Mental Health Assistance Center Form

Mental Health Assistance Center

Our free resource referral line provides one-on-one customer service to help find the best referral option for individuals in need. We’re here to work with you and help you navigate the mental health system.

Contact us anytime Monday-Friday from 8:30 a.m. – 5 p.m. at (918) 585-1213, (405) 943-3700 or using the form below.

* For emergencies, dial or text 988 for the national suicide and crisis lifeline.

Name(Required)
MM slash DD slash YYYY
Gender(Required)
Race(Required)
Ethnicity(Required)
Veteran(Required)
If seeking mental health services, including counseling or medication, do you currently have insurance?(Required)
What is your source of income?
What are you needing assistance with?
This field is for validation purposes and should be left unchanged.