Thank you for referring to Rogers Behavioral Health. To make the admission process as smooth as possible, please provide the following information on this secure form. Please be assured that this referral will be handled in a way that respects your patient’s privacy and complies with HIPAA regulations. You may also make a referral by calling 800-767-4411 in Southeast Wisconsin or 888-927-2203 for our regional clinics.
We will reach out directly to your client/patient to schedule a screening. If you would like to discuss this referral, please contact your outreach representative. For a complete listing click here.