Telephonic Psychiatric Services (TiPS) - Contact Us
General Information
Date:
Referring Primary Care Physician (PCP) Name:
Email:
Referring Primary Care Physician (PCP) Practice:
Referring PCP call back number:
Requested call back date/time: (if requesting a call within 24-hours, please call 800-233-4082, option 3)
reCAPTCHA helps prevent automated form spam.
The submit button will be disabled until you complete the CAPTCHA.
Contact Information