Pediatricians & primary care
The families asking for child psychiatry you can't easily place: complex or stalled ADHD, anxiety with school refusal, mood that's escalating, or medication questions beyond a first-line trial.
A specialist your families can actually reach.
Sigma is a concierge child and adolescent psychiatry practice in California, led by Dr. Ramy Elsawah, with the same depth of care for adults. For the families and patients you'd refer for psychiatric care — but can rarely place quickly — this is a clean, responsive place to send them, and we coordinate the plan back to you.
Who Refers
Built for the referrals that are hard to place
Most psychiatric referrals for children and teens go into a months-long void. The point of a small concierge practice is that they don't have to.
Therapists & counselors
A medication-management partner who coordinates with you, not around you. Your client keeps their therapy with you; we handle the psychiatric piece and stay in touch about the plan.
Neuropsychologists & schools
Evaluations that end in “see a psychiatrist,” and the high-need students and families who can move quickly. We pick up the treatment side and keep your testing and observations in the loop.
How a referral works
Two simple ways to start, whichever is easier for you and the family:
- Send a note. Email RamyMD@sigmapsych.net with the patient’s first name, age, and a one-line reason for referral. For anything with protected health information, send it the way your organization handles PHI; a brief note is all we need to begin.
- Have the family reach out. They can book a consultation or a free 15-minute intro call and mention your name, and we take it from there.
What to expect
California care is concierge and private pay, delivered by secure telehealth. New patients begin with a comprehensive initial evaluation, usually scheduled within days rather than months. We provide a detailed superbill families can submit for possible out-of-network reimbursement.
You stay in the loop
With the patient’s consent, we coordinate on the plan and send you updates that are actually useful, not a fax into a void. Therapy stays with the therapist, testing stays with the neuropsychologist, and primary care stays with the pediatrician. We handle the psychiatric piece and keep the team connected.
We don't pay for referrals. Sigma doesn't pay or accept any payment for referrals, and nothing about sending a patient is tied to the volume or value of patients referred in either direction. We're glad to receive your patients because it's good care, full stop.
Not an emergency service. Sigma offers scheduled telehealth, not 24/7 or crisis coverage. If a patient is in crisis, they should call or text 988 or go to the nearest emergency department.
Refer a Patient
Send them somewhere that has time.
One email starts it. We'll confirm fit honestly, and tell you directly if what the patient needs is something better handled elsewhere.