Client Demographics
Personal, contact, insurance, housing, cultural, legal, and accommodation information.
Thank you. Your secure form was submitted to Heart 2 Heart for review. An appointment request is not a confirmed appointment; our team will contact you about next steps.
Heart 2 Heart is an adult 18+ outpatient IOP in Loma Linda combining evidence-based SUD and mental-health care with psychiatry, medication support, telehealth, and coordinated recovery services. Choose your secure next step below.
Choose your secure next step
Complete new-client paperwork securely
Forms that require a signature first ask for your email address and send you a private link. Check your inbox and spam folder, then open that link to complete and sign the form. Your answers and uploaded identification go directly to Heart 2 Heart through Hush Secure Forms and are not stored on this portal.
Please do not email identification or completed paperwork. Use only the secure buttons below. Staff may contact you if additional signatures or documents are needed. Date fields, including birthdate, today’s date, and appointment date, should be completed with the calendar controls inside the secure form. Complete the required Heart 2 Heart Privacy Notice & 42 CFR Part 2 Consent (step 08) through its secure Hushmail link. The contracted telehealth provider has a separate notice below (step 09).
DHCS License/Certification No. 360171AP
Heart 2 Heart Behavioral Health — 24230 Barton Rd, Suite A, Loma Linda, CA 92354
Personal, contact, insurance, housing, cultural, legal, and accommodation information.
Review the complete agreement, then choose secure digital signing or the printable copy for paper completion.
Review the services, benefits and risks, alternatives, confidentiality, and your rights, then securely acknowledge and sign.
Consent for remote telemedicine and teletherapy care, including benefits and possible risks.
Authorize Heart 2 Heart to release or obtain records for care coordination, legal, or personal purposes.
Authorize or decline use of your image, voice, or likeness. Your services are not affected by your choice.
Upload clear images of the front and back of a government-issued photo ID through encrypted Hush Secure Forms.
Review Heart 2 Heart’s Notice of Privacy Practices and the required consent for treatment, payment, and health care operations. Use the secure Hushmail link to complete and sign online, or open the fillable PDF to print and sign.
Review the HIPAA Notice of Privacy Practices used by our contracted telehealth medical provider, Resiliency Mind+Body Medicine / Stefani LaFrenierre, MD. It explains medical-information privacy rights and how to request privacy support.
Comprehensive support beyond treatment
Programs for adults 18+ led with structure, compassion, and respect—from first inquiry through aftercare.
A structured, person-centered path from connection to continuing support
Our team begins with a confidential conversation, then builds a plan around each person’s goals, safety, clinical needs, and support system. The clinical team—not Dash—determines the appropriate level of care.
Use the secure inquiry hub or call 909-478-0743. We help clients, families, providers, and justice partners find the right next step.
A qualified team reviews needs, safety, co-occurring concerns, insurance, and practical barriers with dignity and respect.
Individual and group counseling, psychiatry, medication support, skills classes, family services, and telehealth can work together.
Relapse prevention, case management, aftercare, and warm referrals help turn treatment progress into sustainable recovery.
We aim to make care timely, trauma-informed, culturally responsive, and measurable. Treatment plans are individualized and updated by the care team as needs change.
Safety, access, accountability, and transparent improvement
Heart 2 Heart is building a quality culture that listens to clients, learns from data, and improves care over time. Any public results will be deidentified and reviewed by the appropriate leadership before release.
Use secure Hush forms for admissions, signatures, and ID uploads. Do not send identification or treatment details by ordinary email or chat.
Telehealth services are provided through our contracted medical provider, Resiliency Mind+Body Medicine, under Stefani LaFrenierre, MD. The provider’s HIPAA notice is available in Admissions for review; secure acknowledgment will be collected through Hush.
Our program information will reflect current DHCS licensing, certification, and level-of-care approvals—not assumptions or marketing shortcuts.
We are designing for adults 18+, mobile users, Spanish-speaking families, people with disabilities, and referral partners who need a clear path.
We plan to monitor the measures below so leaders can see what is working and where clients need more support.
DHCS License/Certification No. 360171AP
24230 Barton Rd, Suite A, Loma Linda, CA 92354
Questions or complaints: sudcomplaints@dhcs.ca.gov