Psychology Referral Information

For patient information, please visit the specialty page.

Psychology Referral Contact Information:

(361) 694-5650
(361) 808-2063

Referring Physicians Must Fax the Following Information:

  • DCH patient referral form (Script signed by PCP and must have ICD 10 codes)
  • Patient must be referred by Primary Care Physician
  • Insurance/Medicaid Card (Front & Back)
  • Demographic Information
  • Physician’s notes/diagnosis
  • Please note: two or more complex Dx required for patient referral.
  • Referral age is toddler to 12 years old.
  • The only Medicaid insurance accepted are Driscoll Health Plan and TMHP Medicaid. All other private insurance is Out of Network.
  • All services are only for short term.
For suspected but not yet diagnosed referral for Autism, please send screening results for Autism. Exp. - (MCHAT)

Patients Must Bring the Following to Appointment:

  • Patient must be accompanied by parent/guardian (with ID) who knows the history
  • Immunization card
  • Report cards to first visit
  • Current medications

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