Make a referral
Referring a client or patient? Start here — our intake team follows up quickly to coordinate care and authorizations.
Choose how to refer
Most referrals are processed the same business day they're received.
PRP Referral Form
Required for Psychiatric Rehabilitation Program admission. Must be completed by the treating mental health provider.
Open referral formPre-Authorization Form
Submitted with clinical documentation so we can secure authorization before services begin.
Open authorization formEmail Intake Directly
Complex case or urgent need? Email our intake coordinator at info@jeichealthcare.com and we'll walk through it together.
Email intakeDocumentation checklist
- Client demographics and current contact information
- Active insurance or Medicaid information
- Current diagnosis with DSM-5 codes
- Most recent psychiatric evaluation or clinical summary
- Medication list and prescriber contact
- Referring provider name, license, and signature
What happens next
Acknowledgement
Intake confirms receipt, usually within one business day.
Eligibility & authorization
We verify coverage and submit for authorization where required.
Assessment scheduled
The client is contacted directly to schedule their assessment.
Provider update
You receive confirmation of enrollment and the assigned care team.