Referral Request for Specialized Mental Health Treatment for Patient Dana M. Curley


[Your Name]

[Your Address]

[City, State, Zip Code]

[Email Address]

[Phone Number]



Kaiser Permanente Member Services


[City, State, Zip Code]

RE: Urgent Request for Referral to La Jolla Recovery for Patient Dana M. Curley

(Member Number: 00 12345678)

Dear Sir/Madam,

I trust this letter finds you in good health. I am writing to address a pressing matter concerning the mental health treatment plan of Dana M. Curley, a valued member of Kaiser Permanente. We are seeking your support in facilitating a Referral and Single Case Agreement for Dana’s treatment at La Jolla Recovery, in light of her worsening condition under the current care provided.

Deteriorating Condition and Urgent Need for Specialized Care

Dana M. Curley has been diagnosed with schizoaffective bipolar type disorder, a complex and challenging condition that demands specialized care. Despite the sincere efforts of her current treatment team led by Dr. Joseph Schuermeyer, MD, and her therapist, her condition has not shown the expected improvement. Instead, it has taken a concerning turn, marked by self-harm tendencies and distressing hallucinations. Consequently, we believe that an immediate change in treatment approach is necessary to prevent further deterioration and to provide Dana with the best possible chance of recovery.

Concerns About Treatment Approach

While we greatly appreciate the dedication and efforts of Dr. Schuermeyer and Dana’s therapist, we must express our reservations about the effectiveness of the current treatment approach. It is evident that Dana’s condition has not responded adequately to the interventions provided so far. We believe that her complex needs require a more comprehensive and specialized treatment strategy.

Identifying a Beacon of Hope: La Jolla Recovery

Given the gravity of the situation, we have identified La Jolla Recovery as a potential beacon of hope. Their outpatient mental health treatment program stands out for its remarkable success in cases akin to Dana’s. Immediate access to their services is critical to arresting the escalating nature of Dana’s symptoms.

Comprehensive and Tailored Treatment Plan

While Dana’s therapist within the Kaiser network has undoubtedly tried to offer effective coping mechanisms, her condition continues to deteriorate. This underscores the urgency for a comprehensive, tailored treatment plan that La Jolla Recovery is well-equipped to provide.

Promise of Improved Mental Health Outcomes

Of paramount importance is La Jolla Recovery’s track record in addressing schizoaffective bipolar type disorder, alongside their proficiency in managing concomitant conditions like depression, anxiety, and ADHD. This presents a promising avenue for Dana’s improved mental health outcomes.

Ensuring Inclusive and Affirming Care

Furthermore, Dana has expressed her concerns about the lack of support for her sexual identity and gender identity within the current treatment framework. La Jolla Recovery’s LGBTQ-affirming environment guarantees her the inclusive care essential for addressing these integral facets of her identity.

Navigating Insurance Complexities with Priority on Health

Additionally, I understand that the situation involves insurance complexities. It is our shared hope that Dana’s health and well-being will take precedence over any bureaucratic hurdles. While the insurance process is navigated, we believe Dana’s immediate need for effective treatment at La Jolla Recovery cannot be compromised.

Request for Thorough Review and Consideration

In accordance with the insurance aspect of Dana’s case, I humbly request Kaiser Permanente’s Medical Administration to expedite a thorough review of Dana M. Curley’s situation. We implore you to consider the proposed Referral and Single Case Agreement, understanding that it aligns with the insurance company’s responsibility to ensure that Dana receives the most effective care available.

Attachment of Patient and Referral Information

We have attached relevant patient information for your reference:

Patient Details:

Name: Dana M. Curley

Date of Birth: 01/30/2005

Kaiser Member Number: 00 12345678

Referral Details:

Referral to: La Jolla Recovery

Treatment Center Address: 3248 Helix Drive, Los Angeles, CA

Treatment Center Phone: (213) 482-1237

I sincerely appreciate your time and consideration in this matter. The urgency of Dana’s situation mandates prompt attention, and we earnestly look forward to your response.

Thank you for your understanding.


[Your Name]

[Your Signature]

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