Refer a Patient: Mental Health Early Intervention Services

To refer a patient to Mental Health Early Intervention Services:

1. Fill out the referral form

Download and complete our mental health and child development referral form. The child's parent or guardian must fill out the release of information / consent for referral portion of the form for us to process the referral.

2. Send it to us

Fax the completed referral form to (510) 985-2202.

Need help?

Get help making referrals
Pediatric Access Center

(877) 822-4453 (877-UC-CHILD)

Fax Oakland: (510) 985-2202

Fax San Francisco: (415) 353-4485

Talk to a physician liaison
Physician Liaison Service

(800) 444-2559

(415) 353-4395