Make a Referral
2. Complete a Release of Information (ROI) Form *REQUIRED* Download our ROI form by clicking here. A completed ROI is required for all referrals to Park Center. We will request the individual's psychiatric medical records from their provider, but we need a completed ROI before we can request the records. We will accept a Park Center ROI or a ROI from the referring agency.
Submit the ROI through one of the ways below
- Upload to page 4 of referral form (preferred method)
- Email to firstname.lastname@example.org
- Fax to 615-650-8917
3. Complete the Online Referral Form *REQUIRED*
(right side of this page). A completed Referral Form is required to make a referral to Park Center.
4. Upload Medical Records. We strongly encourage you to upload the individual's medical records as well as the ROI on page 4 of the online referral form. This will speed up the referral and admission process.
5. If necessary, complete a Recommendation for PSR Services Form. Download the form by clicking here. This form is required for our psychiatric rehabilitation day programs at Park Center South and Emerging Adults only.
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.
Current Program Updates
The following programs are taking referrals:
- IOP/OP (Intensive Outpatient Program & Outpatient Program)
- Psychiatric Rehabilitation & Co-Occurring Psychiatric Rehabilitation day programs
- Supported Residential for men & women
- Emerging Adults Psychiatric Rehabilitation day program (ages 18-24)
- SOAR facility (disability applications for persons in hospitals, jails or prisons)
The following programs are taking referrals for a wait list:
- IPS/Supported Employment
- Emerging Adults Housing for men & women (ages 18-24)
- Independent Residential (estimated 3-6 months to be called for an interview)
- Homeless shelter for women (Safe Haven)
The following programs are not taking referrals at this time. Please check at a later time for updates: