Thank you for referring your patient to Hollywood Mental Health!

The form below is to be completed by healthcare professionals only. Please complete this form only if you have spoken with your patient and they have requested that you submit a referral on their behalf. Please note, our clinicians are independent practitioners and do not offer after hours or emergency services. Patients who require emergency services may be better served by another clinic where these services are available.

Once the referral form is completed, it will be reviewed and shared with potential provider matches. If there is a provider match, we will reach out to the patient directly for scheduling or to be added to a providers waitlist. If we cannot offer services or if the patient is unable to be matched with a provider, we will supply the patient with outside resources and notify the referring provider.

Please allow us 5-7 business days to respond to your referral. If you have any questions, or would like to check the status of your referral, please contact our office at 503-477-4969 or our Intake Specialist directly at newclient@hmhpdx.com.

Due to practitioner availability, specific clinical needs, and a number of other factors, we are not always able to accept everyone seeking services. Please accept our apologies in advance.