How to Submit a Referral for Consultation
External Providers
To request consult services through the Hub, please have the patient/family complete the Mental Health Background Form, PSC-17 screener, ROI & Consent, and include the most relevant clinical note indicative of the reason for referral. Please include the name and phone number of the individual within your practice who our Care Coordinator may contact if they need assistance obtaining additional information/scales/screeners from your patient.
- a completed electronic referral packet may be submitted online at UF Behavioral Health Hub – REDCap
- a completed printable referral packet may be faxed to 850-308-7299
If any additional screeners were administered please include them; the Hub may also request other screeners.
UF Providers
If you are referring within UF Health, please utilize REF929 in Epic when submitting an order for consultative services.
Pensacola Forms
- Hub Fax Cover Sheet
- Letter to Patients/Families – Mental Health Background Form (explanation to share with patients/families)
- Mental Health Background Form (printable version | electronic version)
- Patient Consent/Authorization and Release of Information
- Provider Data Sheet
- Referral Packet (printable version | electronic version)
- Referral-Staffing Form
- Roadmap – English
- Roadmap – Spanish
- What to Expect – for Patients/Families
