Information for Healthcare Providers in Iowa
Thank you for your interest in partnering with the Pine Rest Pella Clinic to help address your patients’ mental health needs.
We are committed to accepting referrals, coordinating services, and providing consultative services whenever possible. As you encounter patients who could benefit from our services, fax us a completed referral form. Our staff will contact the patient to schedule an appointment.
We participate with most health insurance plans, including HMOs. Our staff is happy to assist you or your patient with questions about coverage and payment.
To learn more about our services, please visit:
Free Educational Materials
To order any of the available materials, please use our Online Materials Request Form or call us.
Referring Patients to the Pella Clinic
Referrals for counseling, assessments and other outpatient services are best made via fax.
|OUTPATIENT CLINIC LOCATION||DOWNLOADABLE REFERRAL FORM||FAX NUMBER|
|Pella Clinic||Pella Referral Form||641.621.1493|
|Iowa: Pregnant and Postpartum Consent to Contact||Consent to Contact Fax Form||641.621.1493|
New Client Forms
Clients need to bring a completed New Client form to their first visit. You can print out the appropriate New Client form form below or direct your patient to pinerest.org/outpatient to print out the form at home. The form must be completed in black or blue ink.
Release of Information Forms
|OUTPATIENT CLINIC LOCATION||DOWNLOADABLE FORM||EXAMPLE||FAX NUMBER|
|Pella Clinic||Release of Information Form (Pella, Iowa)||Example||616.281.6394|