Referrals to VRSP can be made by phone (470-795-9390), fax (678-494-4701) or by online submission, whichever is easier for you.
Marietta
630 Cobb Parkway, Ste B
Marietta, GA 30062
Woodstock
7800 Highway 92
Woodstock, GA 30189
Roswell
900 Holcomb Bridge Rd
Roswell, GA 30076
TIPS FOR SUBMITTING THIS FORM:
- Please fill out all fields as thoroughly as possible; not providing detailed information will result in the referral process being delayed.
- All items denoted with a red asterisk are mandatory fields and must be filled out or the form will not be successfully submitted.