Let’s work together.
Please provide the following information at your convenience. This will allow the administration to proceed with scheduling your first visit and enable the clinical staff to begin your treatment planning. Before scheduling your appointment, please respond to the following questions to determine your level of care and to verify eligibility of coverage.
Providing this information allows us to open a patient record for you and book an appointment. Once submitted, we will contact you with appointment options or referrals.
Your privacy and confidentiality are of utmost importance to us, so please rest assured that all information provided will be handled with the highest level of discretion and professional care.
We understand that these topics can be sensitive, so please provide only the information you are comfortable sharing at this time. This information is vital in helping us match you with the most appropriate therapist and treatment approach.
Thank you for your understanding and cooperation. We look forward to supporting you on your healing journey.