- Release of Information Form (PDF) *required for all referrals*
- Upload to page 4 of referral form (preferred method)
- Email to firstname.lastname@example.org
- Fax to 615-650-8917
Recommendation for Psychiatric Rehab. Services Form (PDF)
*required for referrals to Emerge/Emerging Adults 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
We are NOT accepting referrals to Supported Employment at this time.
The following programs are ACCEPTING referrals (no wait list):
- Emerge program (ages 18-24) Learn more
- IOP & OP (Intensive Outpatient Program & Outpatient Program)
- Psychiatric Rehabilitation & Co-Occurring Psychiatric Rehabilitation Day Programs
- SOAR Facility (for individuals who are incarcerated or hospitalized)
The following programs are ACCEPTING referrals for a wait list:
- Supported Residential (housing) for men
- Supported Residential (housing) for women
- Emerging Adults Housing for men & women (ages 18-24)
- Independent Residential (Accepting referrals for multi-bedroom units; Not currently taking referrals for 1-bedroom units)
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?
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.