New Patient Request Form

New Patient Request Form

We provide comprehensive assessment
and treatment options for you and your family.

Our clinicians are experienced in treating ADHD, relationship issues, mood, & anxiety disorders.

Becoming a New Patient

If you are interested in becoming a new patient, please fill out the form below and our Intake Coordinator will contact you within 2 business days for a brief telephone screening to determine if we can best meet your needs.

*E-mail is not a secured form of communication and its confidentiality cannot be assured. By sending messages via e-mail you acknowledge understanding of this risk.