Referral Form
Printable Forms
- Release of Information Form (PDF) *required for all referrals with the exception of SOAR referrals*
- SOAR Release of Information Form (PDF)
*required for all referrals to SOAR and SOAR Facility only* - Recommendation for Psychiatric Rehabilitation Services Form (PDF)
*required for referrals to Emerge Day Program and Psychiatric Rehabilitation Day Program* - Program Eligibility (PDF). Please review this to ensure that our programs are appropriate for the individual you're referring to Park Center.
Current Program Updates
Updated on 11/20/20
We will start accepting SOAR referrals on 11/30/20.
IOP is continuing to take referrals for virtual and telehealth sessions, to be re-opened to in-person sessions in January.
Psychiatric Rehabiliation Day Program (PSR) is taking a hiatus from referrals until mid-January when in-person services will resume.
Note: All Park Center housing programs are accepting referrals contingent upon the following: referred individuals must be willing to take a COVID test and have the ability to self-quarantine while they await the test results. Test results must be negative.
The following programs are ACCEPTING referrals:
- Emerge Day Program
- Emerging Adults Housing (see note above)
- IOP & OP (Intensive Outpatient Program & Outpatient Program)
- Independent Housing (see note above)
- Supported Employment (accepting referrals only from Mental Health Cooperative teams 380, 440, 480, VUMC Street Psychiatry and self-referrals)
- Supported Housing (see note above)
- SOAR Facility (accepting referrals only from Middle Tennessee Mental Health Institute)
FAQs
How does the medical records request process work?
We will request the individual's psychiatric medical records from their provider, but we need a completed Release of Information (ROI) before we can request the records. We will accept a Park Center ROI or a ROI from the referring agency.
How will medical information be used?
Please read our Privacy Policy to learn how medical information may be used.
Is there a way to expedite the referral process?
We strongly encourage you to upload the individual's medical records and the ROI on page 4 of the online referral form. This will speed up the referral and admission process.
Please allow 48 business hours for us to respond to your referral. We will contact you by phone or email with the next steps of the referral process.