Telehealth Consultation

Get a No-Cost Telehealth Consultation

At SUN, our admissions process starts with a no-cost consultation with one of our specialists to determine the best plan for your care. With our no-cost Telehealth Consultation (formerly Virtual Consultation), you can now video chat with an admissions specialist from home. If you or a loved one is experiencing a psychiatric emergency, immediately dial 911 or go to your nearest emergency room. You can also call us at 614-706-2786. This form is not for use in emergency situations.

Set Up Your Consultation Quickly and Easily

- Fill out and submit the following patient information form
- Select and request your preferred date/time to talk with a specialist along with a note describing your situation — check for a confirmation email that we received your request
- A SUN representative will call to confirm your appointment soon after we receive your information
- One of our specialists will reach out to you at the scheduled time for a video chat* and consultation

Watch a Quick Step-by-Step Guide About Our Telehealth Consultations

*IMPORTANT: You will need to have a camera. This will be a video chat and not a phone call.

Patient Information Form

*Indicates required field

Name*

Date of Birth (Month/Date/Year)*

Gender*FemaleMaleOther

Contact Information

Phone Number*

Email Address*

Street*

Street 2

City*

State*

ZIP Code*

Presenting Problem

Describe the problems you are facing. Please be as specific as possible.*

Are you currently experiencing any of these behaviors at this time?

Please call 911 or go to the nearest emergency room. You can also call SUN Behavioral directly at 614-706-2786.

Are you currently using illegal or prescription drugs in a way that is not prescribed?

Insurance Information

The below information will be used to help you understand your benefits if you require further care.

Insurance Name*

Policy Number

Group Number

Primary Subscriber Name (and relationship to patient)

Employer

Insurance Carrier Phone Number

Primary Subscriber Social Security Number

Patient Social Security Number

Are you currently in treatment?

If so, with whom?

If a doctor or anyone else suggested you call SUN Behavioral today, please specify below. If no one, please type "none."
Referring Provider Name

Referring Provider Phone Number

Referring Provider Organization*

How did you find out about this service?*

We are glad you reached out to us and next you will be able to select a consultation window. If this is a psychiatric emergency please dial 911 or go to your nearest emergency room. You may also call SUN Behavioral assessments department at 614-706-2786.