​Behavioral Health services that require a referral or prior authorization


​There are several Behavioral Health (BH) services that require referral or prior authorization.

The following services require a prior authorization through your BH provider by having them complete this form.

  • Health Psychology

If you do not have a BH provider you may then contact the BH triage team through our BH Call Center (608-441-3290) for the following services.

  • Health Psychology
The following services can be accessed through receiving prior authorization from your primary care or BH provider by having them complete this form.
  • Psychological Testing
  • Neuropsychological testing
  • Autism Spectrum Diagnostic Evaluations
  • Electroconvulsive Therapy (ECT)
  • Transcranial Magnetic Stimulation (TMS)  
  • Higher levels of care:  
    • GHC-SCW Foundations Intensive outpatient (IOP) please use this form.
    • For other Intensive Outpatient programs use this form.  
    • Day treatment  
    • Partial hospitalization program (PHP)  
    • Residential Treatment  



The following services require prior authorization from a BH provider.

  • Autism Spectrum Disorder: (ASD) treatment (a diagnosis of ASD must be established prior to treatment initiation). 
  • If you are new to GHC-SCW and have questions about where to go for ASD treatment, please contact Care Management (608) 257-5294.