Appointment Form

Your answers will help your counselor get to know you and concerns better, so please fill out the questions below and submit them to us.  The answers will be sent directly to your counselor who will review them before your first appointment. All answers are confidential and will only be shared with your counselor.

We're here to help.

If you have any questions, please call our office at 800-454-1477 during operating hours:

(Monday – Friday, 8am-5pm Eastern Standard Time.)

If you're experiencing a mental-health emergency, please call 911 for immediate assistance.

Please note: If you do not receive a follow-up email within two business days, please check your SPAM or junk email folders.