Patient Referral

Health professionals who wish to refer patients to mental health services play a crucial role in ensuring individuals receive appropriate care. Recognizing the signs of mental health concerns, such as anxiety, depression, or other emotional or psychological issues, is essential for making timely referrals.

These professionals should maintain open communication with patients, providing reassurance and explaining the benefits of mental health support. Additionally, understanding available resources, such as local therapists, psychiatrists, or mental health programs, can facilitate a smooth referral process.

By collaborating with mental health specialists, healthcare providers contribute to a holistic approach to patient well-being, addressing both physical and mental health needs.

Ultimately, timely referrals can significantly improve a patient’s quality of life by addressing mental health issues early and effectively.

Referral Form

(This page is for medical professionals. If you are a new or returning patient who would like to make an appointment, please click here.)

Referral Information

Referring Clinic / Organization(Required)

Referring Clinician(Required)

Clinician's Email Address(Required)

Clinician's Phone Number(Required)

Patient Information

Patient's First Name(Required)

Patient's Last Namer(Required)

Patient's Phone Number(Required)

Patient's Email(Required)

Patient's Date of Birth(Required)

State(Required)

Patient's Insurance Company(Required)

Preferred Location(Required)

Clinical Information

Clinical services Requested:(Required)TherapistPsychiatric Provider

Please provide a reason for the referral:(Required)

Consent(Required)Referral has been discussed with the patient and they agree.

Serenity adheres to HIPAA compliance and safeguards your personal information. However, we are not responsible for cyberattacks or interference. If you are experiencing an emergency, please dial 911 or visit this page for more resources.