Refer a Patient to Rogers Behavioral Health

To refer a patient to Rogers Behavioral Health for inpatient, residential, partial hospitalization (PHP), intensive outpatient (IOP), or outpatient services, please fill out the form below and indicate the desired level of care. If your patient is in need of inpatient care, please call us 24/7 at 833.308.5887, Option 2. Or, connect with a Rogers Outreach Team member in your region.

Patients experiencing a mental health crisis can call, text, or chat with a trained professional at the 988 Suicide & Crisis Lifeline. For more information, visit 988lifeline.org. If this is a medical emergency, advise your patient to call 911 immediately or go to the nearest emergency room.

What Happens When You Refer a Patient to Rogers

We will reach out directly to your patient to complete a screening with an admissions representative. Afterward, a psychiatrist or clinical director (psychologist) will review the screening and, if approved for a Rogers program, a recommendation for treatment including level of care, will be provided.

For questions regarding an admission, call our staff at 833.308.5887. For specific clinic phone numbers, please visit our Contact Us page.

By policy, Rogers Behavioral Health’s Wisconsin locations recognize referring provider communication as part of the continuum of care; outside of Wisconsin, a release of information is required for any patients receiving addiction treatment services.

Refer a Patient

Patient not at imminent risk of harm: Required: (please check box to approve)

Based on this referral, please be aware that Rogers will reach out directly to your patient. Required: (please check box to approve)

Referral form completed by: Required

Referring provider name: Required

Company: Required

Provider phone number: Required

Provider email: Required

Patient name: Required

Date of birth: Required

Street address: Required

City: Required

State: Required

Postal Code: Required

Country: Required

Patient phone number: Required

Ok to leave voicemail: Required

Parent or Guardian Name:

Parent or Guardian Phone:

Ok to leave voicemail with parent/guardian:

Primary Language: Required

Interpreter requested: Required

Insurance provider:

Insurance policy ID:

Where is the patient seeking treatment? Required

How would you recommend your patient receive care? Required

My patient is interested in Psychiatric outpatient care only (includes psychiatric evaluations and medication management):

My patient is interested in TMS (available in West Allis, WI):

Reason for Referral: (maximum 3,000 characters) Required

Upload additional clinical information or insurance card:

Attachments available:

Community Relations

Wisconsin

Erik Bradley

Kenosha Community Relations Liaison

Erik Bradley is the community relations liaison for Rogers Behavioral Health in Kenosha, working with referents, families, and patients within the community and across the…

Lisa Brown

Appleton Community Relations Liaison

Lisa Brown works as a community relations liaison for Rogers Behavioral Health in Appleton, where her goal is to connect patients, families, and referring providers…

Jennifer Ellis

Brown Deer Community Relations Liaison

Jennifer Ellis is the community relations liaison for Rogers in Brown Deer, connecting patients, families, and referring providers to evidence-based treatment. Jennifer graduated with a…

Jodi Fabbri

West Allis Community Relations Liaison

Jodi Fabbri is a community relations liaison for Rogers Behavioral Health in West Allis, where she connects patients, families, and referring providers to evidence-based treatment…

Sonya Garza

Oconomowoc Community Relations Liaison

Sonya Garza is the community relations liaison for Rogers Behavioral Health in Oconomowoc. Sonya works with referents, families, and patients within the community and across…

Janet Gatlin

MBA

Director, Community Relations

Janet works as the director of community relations, building strong relationships with referring providers, in addition to connecting patients and families to mental health and…

Tyra Gutschow

Sheboygan Community Relations Liaison

Tyra Gutschow is the community relations liaison for Rogers Behavioral Health in Sheboygan, Wisconsin, where she works to create strong relationships within the community and…

Beth Halter

Director, Community Relations

As director of community relations, Beth builds strong relationships with referring providers, in addition to connecting patients and families to mental health and addiction care.…

Meghan MacNeal

Southeastern Wisconsin Community Relations Liaison

Meghan works as a community relations liaison for Rogers Behavioral Health with a focus on the southeastern Wisconsin region. In her role, she is responsible…

Tracy Wattron

Madison Community Relations Liaison

Tracy Wattron is the community relations liaison for Rogers Behavioral Health in Madison, where she works with referents, families, and patients within the community and…

California

Justin Bomberg

San Francisco and Los Angeles Community Relations Liaison

Justin Bomberg is the community relations liaison for Rogers Behavioral Health in San Francisco and Los Angeles. As a native of the Bay Area, Justin…

Colorado

Emma Kilcullen

Denver Community Relations Liaison

Emma Kilcullen is the community relations liaison for Rogers in Denver, where she helps patients, families, and referring providers navigate the available treatment options at…

East Coast

Rick Ramsay

East Coast Community Relations Liaison

Rick serves as a community relations liaison and conference lead at Rogers and is in charge of defining and implementing Rogers’ strategy for national conferences,…

Florida

Jillian Grulich

Tampa Community Relations Liaison

Jillian works with families, referring professionals, and the Tampa community to help them better understand the local treatment options at Rogers Behavioral Health in Tampa…

Georgia

Sydney Scoggins

Atlanta Community Relations Liaison

Sydney Scoggins is the community relations liaison for Rogers Behavioral Health in Atlanta. She works with referents, families, and patients within the community and across…

Illinois

Angela Molloy

Hinsdale Community Relations Liaison

Angela Molloy is the community relations liaison at Rogers Behavioral Health in Hinsdale, Illinois, where she builds meaningful relationships with referral partners and supports families…

Scott Stevens

Skokie Community Relations Liaison

Scott Stevens is the community relations liaison for Rogers Behavioral Health in Skokie, working with referents, families, and patients within the community and across the…

Minnesota

Jamie Bjork

St. Paul Community Relations Liaison

Jamie Bjork is the community relations liaison for Rogers Behavioral Health in St. Paul, Minnesota, where she connects referring providers and people in the community…

Brendon Schmitzer

Minneapolis Community Relations Liaison

Brendon Schmitzer is the community relations liaison for Rogers Behavioral Health in Minneapolis and connects referring providers and community members with Rogers’ life-changing mental health…

Pennsylvania

Kelli Cochran

Philadelphia Community Relations Liaison

Kelli Cochran is the community relations liaison for Rogers Behavioral Health in Philadelphia, working within the community to promote Rogers’ treatment options locally and nationally,…

Tennessee

Elizabeth Edwards

MA, LCAT

Nashville Community Relations Lead

Liz is community relations lead in Nashville, where she supports Rogers’ locations in Southeast Wisconsin, Atlanta, Miami, Nashville, Philadelphia, Seattle, and Tampa. Liz trains and…

Washington

Emelia Carmel

Seattle Community Relations Liaison

Emelia Carmel is the community relations liaison for Rogers Behavioral Health in Seattle, where she helps patients, families, and referring providers connect with Rogers’ life-saving…

Partnering with Rogers

Rogers Behavioral Health is proud to be your trusted partner for evidence-based specialty mental health and substance use treatment. By teaming up with Rogers, you not only ensure that your patients gain the tools and treatment they need to overcome their challenges, but you also gain access to professional development resources including:

Information on Rogers’ newest and upcoming service offerings and locations
Disorder-specific consultation groups
Access to current research studies published by Rogers
Networking opportunities
Free, live, interactive CE webinar series
Local in-person CE seminars

Looking for mental health or addiction resources for your patients, visit our Resources page for more information.