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Professional Referral Information

  • At Belmont we recognize the important relationship mental health professionals have with their patients. To ensure your patient receives quality care in a timely fashion our admissions process is streamlined and staffed with:

    • Psychiatrists
    • Psychologists
    • Master level clinicians
    • Crisis admission counselors

    For professional referrals, contact our 24-hour Access Center to arrange admissions at 1-800-220-HELP (4357).

    How to Refer Your Patient

    To expedite the admissions process we suggest mental health professionals provide us with following patient information:

    Direct admission checklist

    • Patient demographics
    • Patient insurance information (including secondary and tertiary)
    • Axis I – V
    • Current clinical presentation (including any current substance abuse)
    • Current medical status (if available):
    • Current vitalso BAL results
    • UDS results
    • Mental health and substance abuse history
    • Emergency contact and family support information
    • Authorization from all insurance carriers

    Referral for level of care evaluation and outpatient services checklist

    • Patient demographics
    • Patient insurance information (including secondary and tertiary)
    • Current clinical presentation (including any current substance abuse)
    • Medical history
    • Basic mental health and substance abuse history

     

  • Questions? Call Us:

    1.800.220.4357

    Accreditation & Partnerships



    Belmont Behavioral Health Seal

    Joint commission gold seal


    Licenses

    • Department of Health (DOH)
    • Department of Public Welfare (DPW)
    • Division of Drug and Alcohol Program Licensure (DDAPL)
    • Bureau of Drug and Alcohol (BDAP)

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