Clinical and Consulting Services
Payment via Credit Card
Contact the Practice
This form helps prospective patients/clients and providers connect more efficiently and explore whether the requested relationship will be a good fit. As provider skill sets, availability, and financial policies vary, this form helps ensure you find the right provider for your needs.
If you are or believe you are experiencing a medical or psychiatric emergency, including suicidal or homicidal thinking, side effects to medication, or any other urgent or time-sensitive matter in which you need an immediate response, do not use this service. Instead call 911 or go to your closest emergency room. This request is not an emergency or urgent matter.