Referral Sources

Resources for Community Partners

Pine Rest offers a full continuum of outpatient, telehealth outpatient, inpatient and partial hospitalization, and residential behavioral health and addiction services for people of all ages. We participate with most health insurance plans, and our staff is happy to assist you or your patient with questions about coverage and payment.

We provide education, information and more for our community partners:

Referring Patients

Pine Rest is now using the Epic electronic health record for inpatient, outpatient and residential services. If you have access to Care Everywhere, you can now use this online tool to refer patients to Pine Rest. Below is additional information for those providers who do not have access to Care Everywhere.

Psychiatry, In-Person Therapy & Counseling, Teletherapy, Testing & Assessment 

Referring Patients

Referrals for therapy, assessments and other outpatient services can be made via fax, phone call, through Epic Care Everywhere, Great Lakes Health Connect or by completing the form below and faxing to us.

Clients can now complete all new patient forms online, otherwise, they must bring a completed printable New Client form to their first outpatient visit.

Phone: 866.852.4001
Fax: 877.242.6963

Patient Information

For information about a patient’s outpatient care, call the clinic where services are provided. If you do not know which clinic the patient received services, call 866.852.4001.

Inpatient and Partial Hospitalization

Referring Patients

Call 616.455.9200 or 800.678.5500.

If you have a patient in crisis, a call to our hospital’s Contact Center is an important step. Your call helps us gather information for a safe admission and determine if Pine Rest has an appropriate bed available. Clinicians are available 24/7. Primary care physicians, therapists and psychiatrists receive hospital courtesy calls, provided a release of information has been signed.

The following details are needed when a referral is made:

  • Patient Name
  • Birth Date
  • Address & Phone Number
  • Insurance Policy Holder Data
  • Outpatient Provider
  • Medication(s)
  • Current Problem and Symptoms
  • Addictions Data (current use)
  • Significant Medical Problems

For a scheduled evaluation, the patient and/or guardian must bring:

  • Driver’s License or Other Picture I.D.
  • Insurance Card(s)
  • Social Security Number
  • Court Papers
  • Custody Papers
  • Medication List

Patient Information

Call our Health Information Management department at 616.281.6349 for information about the care of a patient in Pine Rest’s hospital including inpatient and partial hospitalization. Primary care physicians, therapists, and psychiatrists receive hospital courtesy calls, provided a release of information has been signed. Staff from Pine Rest’s Contact Center will notify you that your patient has been admitted and let you know who to call for information.*

Mother and Baby Partial Hospitalization, Therapy, Teletherapy

Consent to Contact

Many women are anxious to call Pine Rest even if you have referred them. Having your patient complete and sign our Consent to Contact Form will allow staff from Pine Rest to call the patient to schedule services or discuss care options such as outpatient counseling or our Mother and Baby Partial Hospitalization program.

For Referral and Patient Information, please see the Hospital Based Services and Outpatient & Telehealth tabs above.

Residential Detox, Short-Term Residential, Partial Hospitalization, Outpatient Opioid Detox, Intensive Outpatient, Outpatient Therapy, Teletherapy, Family Services
TAB BOX-Addictions-500x340

Pine Rest offers a full continuum of addiction services that range from residential detoxification to traditional outpatient services. All of the service components in the continuum welcome those who also have mental health disorders. We believe that there should be no wrong door for individuals to access substance use disorder treatment.

With one call to 866.852.4001 we can guide you or your patient through the process of inquiry, assessment and admission to the most appropriate level of care. We will assist with understanding insurance benefit, explain what other sources of funding might be available and qualify your patient for treatment.

Obtaining Treatment Information: Release of Information Forms

*In compliance with both The Michigan Mental Health Code and HIPAA, we can only share information with you if the patient has signed a release of information. If you are unable to get the information that you are requesting, guide the patient through completing the release of information following the example and directions provided. Fax the completed release of information to the appropriate location with a statement about what information you are requesting.

HOSPITAL & PARTIAL PROGRAMS FORM EXAMPLE FAX NUMBER
Inpatient & Partial Hospitalization Release of Info Form: Inpatient & Partial Release of Info
Form Example
616.493.6043
OUTPATIENT CLINICS FORM EXAMPLE FAX NUMBER
All Michigan Clinics Printable/Downloadable Form (Michigan) Michigan Example 616.281.6394
Pella Clinic (Iowa) Printable/Downloadable Form (Iowa) Iowa Example 616.281.6394
TELEHEALTH FORM EXAMPLE FAX NUMBER
All Michigan Residents Online Form (Michigan)
All Iowa Residents Online Form (Iowa)

Online and Printed Materials for Patients

We have a large online library of blog articles and publications available on most behavioral health topics … including anxiety, anger, depression, dementia, substance use disorder and more. To find these publications, look at top right of our website navigation for the RESOURCES tab. Please feel to share these links with your patients.

Printed versions of these publications are available in limited quantities to our community partners.

Presentations and Tours

We are eager to connect with health care providers. Please contact a Pine Rest Referral Relations Coordinator to request an individual meeting, tour, or group presentation.

Email referralrelations@pinerest.org or call 616.222.4555 to schedule today!