Referral Sources

Pine Rest is Open for Those in Need of Care

Resources for Community Partners

Pine Rest offers a full continuum of behavioral health services for people of all ages including psychiatric urgent care, inpatient, partial hospitalization programs, outpatient, teletherapy, residential, and addiction treatment. 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 resources for our community partners:

Referring Patients

Pine Rest is on the Epic electronic health record for inpatient, outpatient and residential services.

Below is referral information and how to access patient information.


  • Virtual Psychiatric Urgent Care for Ages 18+
  • Walk-In Psychiatric Urgent Care for Ages 18+

Referring Patients

The center is designed to provide immediate assessment and treatment for people experiencing acute psychiatric symptoms who cannot wait for routine outpatient intervention. Walk-ins are welcome, and virtual appointments are available by calling. Most commercial insurance, Medicare and Medicaid health plans cover this service. If you have questions or your client has Medicaid, please call.

Phone: 616.455.9200

Referring Patients

Referrals for therapy, assessments and other outpatient services can be made via fax, phone call, 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


Referral Form     GLHC New Patient

Lakeland Psychiatric Access Clinic Forms

Lakeland Referral (printable)    Lakeland Referral (online)

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.

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. Pine Rest staff will notify you that your patient has been admitted and let you know who to call for information.*

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

Addiction Services

  • Medication Assisted Treatment
  • Residential Detox
  • Short-Term Residential
  • Partial Hospitalization
  • Intensive Outpatient Program
  • Outpatient Individual & Group Therapy
  • Teletherapy
  • Peer Recovery Coaching
  • 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.

Residential Services

We provide residential services for:

  • Adolescent, short-term (Grand Rapids)
  • Adult Psychiatric, short-term (Kalamazoo)
  • Adult Psychiatric, short-term (Grand Rapids)
  • Adult Developmentally Disabled, long-term (Grand Rapids)

For referral or access to services, call 616.281.0061.

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.

Urgent Care, Inpatient & Partial Hospitalization Release of Info Form: Inpatient & Partial Release of Info
Form Example
All Michigan Clinics Printable/Downloadable Form (Michigan)

Online Form (Michigan)

Michigan Example 616.281.6394
Lakeland Clinic / Psychiatric Access only Printable/Downloadable Form (Lakeland)
All Michigan Residents Online Form (Michigan)

*Outpatient clients may use the printable forms or the Telehealth online forms.

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 or call 616.222.4555 to schedule today!