LGBTQ+ Digital Mental Health Program: Submit a Referral
Make a Mental Health Referral
Referrals are currently open to support and care professionals on a limited basis during the program’s initial pilot phase. Please complete the form with the Participant. Review the instructions carefully on the Participant Referral form before you begin. They also include information on the next steps of the process for you and the Participant.
The program supports participants with the following eligibility:
- Member of the LGBTQ+ community.
- 60+ older adults or adults 18+ living with a disability.
- Resident of San Francisco.
- Appropriate (at onset or post- tech training) level of technology literacy to support Telehealth participation (email, video sessions, signing electronically,
etc.). - Mild-moderate mental health diagnoses and/or symptoms.
- NOT currently engaged in ongoing psychotherapy.
Connect to Care
We appreciate your patience in submitting the referral! Our form is thorough, designed to support our program funding and to connect Participants to the next step in the process which is a phone screening.
You have three options to submit the referral:
- Fill out the below embedded form
- Click through to the form in its own window or
- Download the PDF version to print, fill out and then enter the information into one of the online forms.
We only accept referrals via the online form.
Connection. Support. Community.
For folks seeking a more casual approach to support and connection, there are many groups around the city hosted by different organizations. Click through each link to learn more about currently available in-person and/or online support groups.
Made possible by funding from the City and County of San Francisco’s Department of Disability and Aging Services (DAS).
