External Referrals

Hello Valued Community Partner,

Thank you for your referral to Axis Health System. In most instances, a staff member will contact the referred individual within 2-3 business days from the time this referral is received to assist the referred individual in enrolling in services. A follow-up notice with the referral disposition will also be sent to the referring party within 30 days. Please call 970-335-2387 or email referrals@axishealthsystem.org with any questions.


The procedure for scheduling aftercare appointments post-inpatient placement is as follows:

  • To request appointments for patients residing in Montrose, Delta, Ouray, Gunnison, San Miguel, Durango, Cortez, Dove Creek, or Pagosa Springs counties, please choose one of the following:
  • Encrypt an email to DischargePlanners@axishealthsystem.org
  • Fax the referral packet to 970-335-2353


The procedure for scheduling step-down placement from inpatient to Axis Health System - Regional Crisis Centers is as follows:

  • To request services for Montrose Regional Crisis Center, please call 970-252-3203 and request to speak with a Case Manager. Please fax the patient’s discharge summary to 970-249-8793.
  • To request services for Durango Regional Crisis Center, please call 970-403-0180 and request to speak with a Case Manager. Please fax the patient’s discharge summary to 970-403-0191.


Need help now? 24/7 Axis Care Line is 970-247-5245.


Thank you,

Axis Health System


* Required Fields

 
 
mm/dd/yyyy
 
 

REFERRING AGENCY INFORMATION

 
 

If name does not appear in dropdown, please type it here and press the "TAB" key to enter text.

 

Please select this flag so that the referring agency can be added to the list.

 
 

Please list your name, phone number, email, and/or fax number. This contact information is important for a follow-up with the referring agency.

 
 
 

PATIENT INFORMATION

 
 
 
 
 
mm/dd/yyyy
 

Please enter Guardian name if person referred is a minor.

 

Please enter Guardian phone number/email if person referred is a minor.

 
 

If applicable.

 
 

If "yes" was selected for Positive Depression Screening, please enter the date of the screening here.

 
mm/dd/yyyy
 
 

Please enter the nearest location to the patient's physical address to see all available services below.

 
 

WHICH PROGRAMS ARE YOU REFERRING THE PATIENT FOR?


Select the appropriate "Nearest Clinic Location" above to populate the available services below.

 
 
 

PATIENT REFERRAL CONSENT

 
 
 
 
 

Please attach any additional referral documentation here.

Drop your files here