Physicians/Behavioral Health Specialists:
- Complete 'Behavioral Health Screening Form for Assessment and Treatment as Medically Necessary' for appropriate age group. Please be sure to indicate how mental health symptoms are impacting your patient's daily functioning.
- Complete ACCESS Program fax cover sheet up to 'Referred To:'
- Fax completed screening tool (Child 0-5, Child 6-17, or Adult) and ACCESS Program fax cover sheet to ACCESS at 510-346-1083.
- Direct patient to call ACCESS (1-800-491-9099) the following business day to speak with an ACCESS clinician and complete the referral process.
- If client doesn't contact ACCESS within 3 business days of referral request, ACCESS will fax back cover sheet to referring provider with statement "No call received from client".
- Indicate on the fax cover sheet if you're concerned your patient may not call ACCESS and would like ACCESS staff to reach out.
- Finalize referral process and contact consumer with referral contact information.
- Complete bottom portion of fax cover sheet (referral information) and fax back to referring physician/clinician.
- Include physician/clinician's name and phone number in the referral letter to the specialty mental health provider(s) with request that they connect with referring provider.
- If patient doesn't contact ACCESS within 3 business days of referral request, ACCESS will fax back cover sheet to referring provider with statement "No call received from patient".