At Access Hospital Dayton, we strive to make the referral process as simple as 1-2-3!

Step 1: Determine Clinical Eligibility



  • Does the patient require inpatient detox, substance abuse, mental health, or dual-diagnosis services?
  • Is the patient 18 years or older?


Step 2: Determine Financial Eligibility



  • Does the patient have Medicare bed days available, Managed Care, private insurance, or the ability to self-pay?



Step 3: Submit Patient Information for Review

If you answered “Yes” to all of the above questions, fax the following patient information to 937.965.4950 for immediate review:



  • Demographic information
  • Insurance information
  • Patient’s photo ID
  • Guardian or healthcare power of attorney contact information (if applicable)
  • An assessment that includes presenting problems and behaviors/symptoms describing how the individual meets criteria for acute inpatient care
  • Diagnosis sheet for medical and psychiatric evaluation
  • Complete medication list
  • Last doctor’s note
  • Most recent lab work
  • Pink slip (if applicable)
  • Contact information for a nurse-to-nurse report
  • Completed Voluntary Admission Form



Upon receipt, an Admissions Specialist will confirm clinical and financial eligibility and then follow-up directly with an admission decision!

If you have any questions about or during the referral process, please do not hesitate to call us at 937.256.7801.