Submit this form to request a case consult related to pediatric mental health care. A specialist from our clinical team will contact you within 1-2 days to discuss your questions.

NM-ABC offers these provider-to-provider consults at no cost (we do not offer direct patient evaluations). This program is a partnership between the UNM Center for Development and Disability and the NM Department of Health.

Note: please DO NOT include patient information on this form.

Question Title

* 1. Provider's contact info

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* 2. Consult reason (check all that apply)

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* 3. Preferred time for consult (we will call the phone # listed above); if this field is left blank we will reach out to find the best time.

Date
Time
Thank you! If you have any questions, feel free to contact us at (505) 272-3459 or nmabc@salud.unm.edu
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