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Locations
Services
Emergency Psychiatric
Adult Mental Health
Children, Youth & Family
Primary Care
Substance Use
Justice & Outreach
About
About Us
Our Leadership Team
Contact Us
Careers
Blog
Make a Referral
Access Services
Consumer Portal
Locations
Services
Emergency Psychiatric
Adult Mental Health
Children, Youth & Family
Primary Care
Substance Use
Justice & Outreach
About
About Us
Our Leadership Team
Contact Us
Careers
Blog
Make a Referral
Access Services
Consumer Portal
The Latest from MHC
August 1, 2025 •
Emergency Mental Health
Mobile Crisis Response Teams Transform Mental Health Emergency Care
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Emergency Mental Health
Crisis Mental Health Services: Finding Help When You Need It Most
July 30, 2025 •
Mental Health Tips
Emergency Psychiatric Services in Tennessee: What You Need to Know
July 21, 2025 •
Community Impact
Expanding Access: How MHC Is Reaching Rural Tennessee Communities
July 21, 2025 •
Whole-Person Care
What Is Whole-Person Mental Health Care — and Why Does It Matter?
July 21, 2025 •
For Referrers
A Quick Guide to Referring Clients to MHC Services
Take the First Step
"
*
" indicates required fields
First Name
*
Last Name
*
Email
*
Phone
*
Do you have insurance? If so, what kind?
*
Date of Birth
*
MM slash DD slash YYYY
Do you need an interpreter? If so, what language?
*
Please provide any additional information, including present issues or symptoms
*
SMS Consent
By submitting this form, you agree to receive text messages from Mental Health Cooperative. Message and data rates may apply. Reply STOP to opt out.
Fill out the form to make a referral
"
*
" indicates required fields
Step 1.
Who is making this referral?
*
Friend or Family Member
School or University Staff
Community Partner or Agency
Medical Provider
Are you referring a Child or Adult?
*
Child
Adult
Your First Name
*
Your Last Name
*
Your Email
*
Your Phone
*
Step 2.
Parent/Guardian's Full Name
*
Parent/Guardian's Phone Number
*
Parent/Guardian's Email
Has parent/guardian been notified MHC will contact them?
*
Yes
No
Step 2.
Your Relationship to Client
*
Individual's First Name
*
Individual's Last Name
*
Individual's Phone Number
*
Individual's Email
Individual's Date of Birth
*
MM slash DD slash YYYY
Step 3.
Your Organization's Name
*
Organization's Phone
*
Last step
If client has insurance, please indicate what kind.
*
If client needs an interpreter, please specify what language.
Please provide any additional information, including present issues or symptoms
*
English
French
German
Arabic
Chinese (Hong Kong)
Chinese (China)
Spanish
