Let's get started!
We'd like to learn more about what brings you to us. To help us better understand your goals and preferences, we'll ask you to:
- Share some basic information so we can contact you.
- Tell us more about the type of care you're seeking.
- Elect the method you intend to use to pay for your care.
This questionnaire will take about 5 minutes and you may use your mobile phone, tablet or computer. All of the information you disclose is protected by HIPAA and will remain confidental.
We make every effort to respond as soon as possible. However, if you contact us after-hours, over the weekend, or on a holiday, our follow-up may be delayed.
If you or someone you know is experiencing a life-threatening emergency or is in crisis, call 911 or go to the nearest emergency room. Click here for crisis resources that are available 24/7.