Sample Referral Letters for Hormone Therapy and Gender-Confirming Surgeries

Often insurance companies who cover hormone replacement therapy and gender-confirming surgeries require a letter from a therapist or a doctor confirming that transgender clients are able to give informed consent about the medical care they are seeking, and/or have fulfilled certain requirements needed before surgery. You may need to provide:…

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Erin Davis, MA, NCC – Marion

counseling

Erin Davis, MA, NCC Family Service Society, Inc. 101 S. Washington Street Marion, IN 46952 Therapist Phone: (765) 662-9971 ext. 122 Website: http://famservices.com Email: edavis@famservices.com Familiar with WPATH SOC v.7?: Yes Provides Referral Letters for HRT?: Yes Provides Referral Letters for Surgeries?: Yes Experience working with trans-identified persons?: This therapist…

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Kelly Bishop Bohren, LCSW

counseling

Kelly Bishop Bohren, LCSW 8 N. Morgan Blvd Valparaiso, IN 46383 Clinic or Practice: Private Practice Therapist Phone: 219-464-9495 Email: kbishopbohren@gmail.com Familiar with WPATH SOC v.7?: Yes Provides Referral Letters for HRT?: Yes Provides Referral Letters for Surgeries?: Yes Experience working with trans* identified persons?: Received initial training while working…

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Jeanne Harber-Porter, MSW, LCSW, ACSW – Fort Wayne

counseling

map of all Therapists & Counselors Jeanne Harber-Porter Consulting & Counseling Associates 4214 Hobson Court Fort Wayne, IN 46815 Phone: (260) 486-5251 Website: http://www.ccagroup.org/ email: jporter@cca.org Transition-Related Services: Counseling, Letters for Transition-Related Care Other Care Services: Psychological Care Payment: Accepts some forms of insurance – visit website for details. Familiar…

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Wallace, Dr. Christi – MD – Fort Wayne / South Whitley

Health Care

Dr. Christi Wallace, MD – Fort Wayne Parkview Health – Doctor Bio Page 4665 State Road 5 South Whitley, IN 46787 (260) 248-9980 Specialty: PPG – Family Medicine Trans-related services: Hormone Replacement Therapy for adults, Puberty blockers for trans youth Letters of referral: For change of name, transition-related surgeries This…

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Kane, Dr. Erica – PsyD, HSPP – New Castle

Dr. Erica Kane, PsyD, HSPP Kane Loveridge Psychological Services LLC 2020 S. Memorial Dr., Suite I New Castle, IN 47362 Phone: 765-465-3387 Email: drkane@kanepsychological.com Website: http://www.kanepsychological.com Familiar with WPATH SOC v.7?: Yes Provides Referral Letters for HRT?: Yes Provides Referral Letters for Surgeries?: Yes Experience working with trans-identified persons?: I…

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Dr. Rodney E. Timbrook, Phd, HSPP – Fort Wayne

Dr. Rodney E. Timbrook, Phd, HSPP Psychological Service Associates, Inc. 3421 E State Blvd. Fort Wayne, Indiana 46805 (260) 582-4217 Website: http://www.drrodneytimbrook.com/ Psychology Today Profile I’ve been working with transgender people for about 25 years and I am familiar with the WPATH standards. Does referral letters for hormone replacement therapy.

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Dawn Bontrager, LCSW, MDiv – Mishawaka

Dawn Bontrager, LCSW, MDiv Bontrager Therapy Services 203 E Mishawaka Ave Mishawaka, IN 46545 574-256-3699 email: dawnb@dawnbontrager.com Psychology Today Profile Familiar with WPATH Standards of Care Writes referral letters for medical providers for HRT and transition-related surgeries Finances Avg Cost (per session): $70 – $110 Sliding Scale: No Accepted Payment…

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Green Line Wellness – Louisville, Kentucky

Green Line Wellness 714 Lyndon Lane, Suite One Louisville, KY 40222 (502) 426-2777 info@greenlinewellness.com familiar with WPATH Standards of Care Provide letters of referral for HRT and gender-confirming surgeries Finances Avg Cost (per session): $80 – $150 Sliding Scale: Yes Accepted Payment Methods: American Express, Cash, Check, Mastercard, Visa Accepted…

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Howard Brown Health Center – Chicago

Howard Brown Health Center

map of all Medical Doctors Howard Brown Health Center 4025 N.Sheridan Road Chicago, IL 60613 (773) 388-1600 Website: Howard Brown Health Center Aris Health by Howard Brown Health Center 3245 N. Halsted Street Chicago, IL 60657 (773) 388-1600 Howard Brown Health Center is an Informed Consent Clinic This clinic was…

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