Mental Health to Psychiatry Referral Form

Streamline Mental Health Referrals with Paperform

When a mental health provider needs to refer a client to psychiatric services, clear and comprehensive documentation is essential. This Mental Health to Psychiatry Referral Form template is designed specifically for therapists, counselors, psychologists, and other mental health professionals who need to communicate critical patient information to psychiatrists efficiently and securely.

Built for Behavioral Health Workflows

This template captures everything a psychiatrist needs to conduct an informed evaluation: presenting symptoms, behavioral health assessment findings, current and past medication history, therapeutic interventions attempted, risk factors including self-harm and substance use, and urgency level indicators. By organizing this information in a structured, professional format, you reduce back-and-forth communication and help ensure patients receive timely, appropriate care.

The form uses conditional logic to reveal relevant follow-up questions based on initial responses—for example, detailed medication history fields appear only when prior psychiatric medications are indicated, and risk assessment sections expand based on identified concerns. This keeps the form streamlined for the referring provider while ensuring comprehensive documentation when needed.

Secure, Professional, and Coordinated Care

Paperform is SOC 2 Type II compliant and offers robust security features that healthcare providers trust, though it's important to note that Paperform is not a HIPAA-compliant solution. For practices that require HIPAA compliance, you'll need to implement additional safeguards or use this template as a foundation for an internal system.

For mental health practices using Paperform, you can connect submissions to your practice management software, send secure notifications to psychiatric offices, and maintain organized records of all referrals. With Stepper, you can automate the entire referral workflow—triggering follow-up tasks, updating your EHR, notifying the patient about next steps, and tracking referral status without manual coordination.

Designed for Mental Health Professionals

Whether you're a solo therapist, group practice administrator, community mental health center, or integrated care coordinator, this template helps you provide seamless continuity of care. It's optimized for desktop and mobile use, so you can complete referrals from your office or after a crisis intervention in the field.

Paperform's document-style editor makes it easy to customize this template to match your practice's specific referral protocols, add your branding, or modify assessment criteria to align with your organization's standards. Get started today and transform your referral process from scattered paperwork into a streamlined, professional workflow.