Request for PSI Perinatal Psychiatric Consultation

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> Please fill out this form in preparation for a call with the PSI Perinatal Psychiatric Consult Line. We will contact you to arrange an appointment with one of the consultants.

> The Consultation Line is not an emergency resource. We will return your message within 24 hours (one business day). In case of emergency, please follow your usual crisis protocol.

> If you are looking for PSI support and resources for a mom or family member, please call 800-944-4773 and leave a message on the HelpLine extension. (1 for Spanish, 2 for English)

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www.postpartum.net

Are you a medical professional seeking a consult?

I am a medical professional requesting a consult

I work in a medical office and am filling out this form on behalf of a medical professional

I am a parent or family member in need of support and resources

I am a mental health or affiliated professional seeking resources, but not a medical provider.

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