Pediatric psychologists have expertise in the assessment and management of psychosocial comorbidities in children with chronic diseases, with the goal of improving health outcomes. However, integrating pediatric psychology services into medical clinic standard of care can be challenging at both the patient, provider, and institution levels, particularly when these services are new to a preexisting clinic. Youth with epilepsy are at particular risk for psychosocial comorbidities, yet most do not receive appropriate mental health care. The purpose of this article is to describe the development and preliminary implementation of a tiered psychosocial service into a preestablished pediatric epilepsy clinic. Uptake data suggest high rates of initial service acceptability over the first 6 months, with 77% of patients (n = 275 of 356) agreeing to meet with the pediatric psychologist for a screening visit. Barriers and facilitators of building a psychosocial service in the context of an interdisciplinary specialty clinic are discussed. Overall, this model of care could be adapted to other pediatric populations.