Partner referral

Professional referral

For clinicians, schools, social services and partner organizations. Assistance may involve mental health treatment, evaluations, medication-related support, telehealth or local provider care, and care navigation and coordination. Documented consent is required before we make contact.

If you need help right now

This form is not monitored around the clock and is not an emergency service. If you or someone else is in immediate danger, contact your local emergency number or a crisis line right away.

Crisis resources in the library

If you need help right now

This form is not monitored around the clock and is not an emergency service. If you or someone else is in immediate danger, contact your local emergency number or a crisis line right away.

Crisis resources in the library

Before you submit this form

This form is not an emergency service and is not monitored around the clock.
Do not use it to report immediate danger, thoughts of suicide or self-harm, or abuse in progress.
Submitting a request does not create a clinician-patient relationship and does not begin treatment.
Submitting a request does not guarantee eligibility, approval, funding, a provider, an appointment or an outcome.
Share only what is needed to review the request. Please do not send full medical records or unnecessary clinical detail.
If you are submitting on behalf of someone else, only share information you are permitted to share.

What happens next

1. The intake team reads your request.
2. Someone makes contact using the method you chose.
3. Together you decide which program or service fits.

A member of the support team reviews new requests during working hours. We aim to make first contact within three working days. This is a coordination service, not urgent or clinical care.

What we can and cannot promise

Assistance is based on established charitable eligibility criteria, available funding, program requirements, provider availability, and individual circumstances.
The MindBridge Health may set limits on medications, visits, treatment duration, or total financial support.
Independent providers remain responsible for their own clinical decisions and services.
A referral does not guarantee that a provider will accept the individual.
We do not guarantee a particular prescription, diagnosis, clinician, appointment time, or outcome.
Crisis and emergency needs are handled through our crisis-support pathway.

Your privacy

What you share is stored securely and is only visible to the support team members handling your request. We do not sell or publish it. Limited information may be shared with service providers or independent care providers as described in our Privacy Policy. Contact us to ask about access or deletion, subject to legal retention requirements.

Other routes

Ask for yourself Refer someone you know

About you and your organization