The Oklahoma Mental Health Network (OMHN) is a comprehensive network of all mental health services and resources across the state of Oklahoma including adjunctive situations such as domestic violence, developmental disabilities, and family needs. This form asks basic questions about your services relevant to pediatric mental health. The intended use of this information is to provide a referral network for the Oklahoma Child and Adolescent Psychiatry and Mental Health Access Program (OKCAPMAP) to assist pediatric serving (0-21 years old) primary care providers across the state with successful referrals to therapeutic services and supports. This survey is for practices and businesses. Please only complete this survey for a business or practice.

Thank you for taking the time to complete this survey and for helping bridge the gap in pediatric mental health care in Oklahoma.