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Provider Referral Form

Providers please submit referrals directly through the form below and we will reach out to your patient within 1-2 business days. Please feel free to contact our Practice Director, Tristan Ramsey, with any questions.

Email: tramsey@galiacollaborative.com

Phone: (513)216-0068 x700

Fax: (513)216-0068

Provider Information

Patient Information

Referring to:
Max. file size: 300 MB.

Odessa is a program of Galia Collaborative, a mental health practice focused on elevating the impact of girls and women through modern mental health. For Galia's full range of mental health services, visit the website