• Therapy Referral Form - Ellie Mental Health

    Appt requesting form - outside of MN
  • Our team schedules appointments three weeks prior to opening a clinic. If you are interested in scheduling with a different clinic, please check on our website for opening updates. 

    To make a referral for a new clinic opening within the next three weeks or that is already open, please complete the following form. A member of the Ellie team will be in touch within 1-3 business days.

    For MN clinics, please click here.

    Thanks! 

  • If you don't see your state listed here, we may not be ready to take clients in your state, just yet. Check this form out to see if we are coming to your state and to be notified when we are ready to schedule you! Look up other states

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  • As soon as we receive a referral, Ellie staff will begin processing and verifying insurance coverage. If a client has "inactive" insurance, we will not be able to schedule an intake until we have confirmed that insurance is active or the referral would like to proceed with cash pay options. Thank you for working with us. We appreciate the support and assistance in coordination.


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