Toggle NavigationHomeSchedule an AppointmentAbout UsEmergency ResourcesFor ClientsConsultation ServicesHomeSchedule an AppointmentAbout UsEmergency ResourcesFor ClientsConsultation Services joshhamilton | Psychiatric & Behavioral Health Hospitals and Providers If you'd like to refer a patient to us, simply complete the form below. Patient Name *Gender *MaleFemaleAge*Child (0-9)Adolescent (10-17)Adult (18+)Guardian Name (if applicable) Patient Phone Number *Patient Email *Known/Suspected Diagnoses Key Concerns to be Addressed Recommended Services *Diagnostic ClarificationMedication EvaluationMedication ManagementPsychotherapyCounselingOtherReferring Provider/Organization *Office Phone Number *Referring Provider's Email Proposed Appointment Date & Time Patient Insurance Company Who should we contact to schedule? *Patient/GuardianReferring ProviderThis site uses Google reCAPTCHA technology to fight spam. Your use of reCAPTCHA is subject to Google's Privacy Policy and Terms of Service.Send MessageThank you! Your message was sent successfully. / PreviousNextPausePlayClose