REFERRAL

Refer a patient.

A simple, direct referral process for pediatricians, primary care providers, therapists, schools, and community partners.

Why Refer to Us

Missing Pieces Telehealth Psych provides timely, coordinated psychiatric care for children, teens, and adults. We partner with referrers to close the loop. We focus on a continuum of care and maintain open communication, warm hand-offs, and clear records so your patients stay your patients.

Why Refer to Us
PROCESS

Referral Process

01

Submit the form below

Provide the patient name, contact information, reason for referral, and any urgency notes.

02

We confirm receipt

Our team confirms within one business day and reaches out to the patient to schedule.

03

We close the loop

With patient consent, we send a clinical summary back to the referring provider after the initial evaluation.

Complete The Referral Form

    Provider referral

    For referring providers. Takes about six minutes. You can save and finish later.

    Step 1 of 3Provider
    Step 2 of 3Patient
    Step 3 of 3Referral
    Referring provider information

    Please provide information about the referring provider and practice.

    How we reach you
    Preferred contact method *
    PhoneSecure emailFax
    Referral Consultation

    For Patients

    If you are a patient looking to be referred, please ask your provider to use this page, or book directly online. We accept self-referrals as well.

    LATEST GUIDANCE

    Guidance and Insights for Mental Wellness Journey

    Navigating Postpartum Mood Shifts & Emotional Health

    Navigating Postpartum Mood Shifts & Emotional Health

    Read More →
    Cultivating Self-Compassion and Healthy Personal Boundaries

    Cultivating Self-Compassion and Healthy Personal Boundaries

    Read More →
    Grounding Techniques and Breathing Exercises for Panic Relief

    Grounding Techniques and Breathing Exercises for Panic Relief

    Read More →