PROVIDER REFERRALS

We welcome and appreciate your referrals! 

Connect your patient with one of our Providers by choosing either option below:

1. Have the patient register and schedule directly online OR
2. You complete and submit the short referral form below

Referral FORM

What we do after receiving your referral

By the next business day after receiving your completed referral form, we will call the patient to schedule an appointment. We will make at least 3 attempts to contact the patient.

If we are unable to reach the patient, if they do not return our messages and/or they choose not to schedule with us, we will notify you that we were unable to schedule an appointment.

Services we do NOT provide

Please note that there are some services that we do NOT provide, such as:

• No detox, court mandated therapy, forensic psychology, or sex offender treatment
• No counseling for schizophrenia, psychosis or mania. 
• ​No ADHD testing-Visit our resource page for sites that offer ADHD testing
  • Our psychiatrist can do symptom diagnosis of ADHD and can prescribe ADHD medications for ages 18+. 
• No higher level of care: We offer outpatient services only. We do not have IOP, PHP, residential or inpatient programs.

Insurances we accept

Insurance: View insurances we accept HERE.
​
We do NOT accept Anthem, Blue Cross Blue Shield, UHC Community, Medicare, Medicaid, or Caresource. 
​
Cynthia Churchill, MD, does not accept UHC/UMR/UBH

Consultation with a provider

​Consultation with a provider
If you need to connect with one of our providers for a consultation prior to the patient's appointment or in the process of the referral, please use the contact form on the bottom of the provider's profile page.

​We do NOT provide ADHD testing. Visit our resource page for sites that offer ADHD testing.

Patients need to physically be in Ohio, even for virtual visits.