How to Refer a Patient

To request a referral:

  • Complete the Online Referral form below.
  • Or you can make a referral by calling (859) 277-1008 for a direct scheduler.
  • Or … you can also fax a complete copy of our referral form with the patient’s demographic and recent notes to (859) 277-1083.

*For most patients seen in our Lexington office, we try to them scheduled within two weeks.

Main Office

Bluegrass Health Psychology
2220 Young Drive
Lexington, KY 40505

Office Hours

Appointments are available during normal business hours:

  • Monday to Thursday: 8:00am to 5:00pm
  • Friday: 8:00am to 4:00pm.

Phone

Phone: (859) 277-1008
Fax: (859) 277-1083

Email

info@bluegrasshealthpsychology.com

Online Referral Form

We value our relationship with our referring physicians.  We will provide excellent care to your patient and timely feedback to you.  Thank you for choosing Bluegrass Health Psychology for your healthcare needs.

An (*) asterisk indicates a required field.

    REFERRING PROVIDER DETAILS

    Provider Name*

    Provider Specialty

    Provider's Location or Facility Name*

    Provider Phone*

    Provider Email*

    Reason for Referral*

    PATIENT INFORMATION

    First Name*

    Last Name*

    Email*

    Telephone*:

    Patient's Address (Street Address, City, State and Zip)

    Patient's Insurance Company*:

    Patient's Insurance Policy ID Number*:

    Patient's Secondary Insurance:

    Any comments

    Let's work together.

    We are clinical and health psychologists with specialized training to help people cope with a variety of medical conditions including:

    • Bariatric Surgery Evaluation
    • Spinal Cord & Peripheral Nerve Stimulator Evaluation
    • Intrathecal Pain Pump Evaluations
    • Insomnia Evaluation
    • Chronic Pain Evaluation
    • Insomnia Treatment & CPAP Tolerance
    • Behavioral Pain Management & Coping Skills
    • Post-Surgical Adjustment & Coping