Step 1 Of 3

New intake packet must be completed 48hrs prior to appointment or appointment will be canceled.
Cancellation or Rescheduling must be done 24hrs prior to appointment.
Failure to attend appointment or late cancellation will result in a $50 fee. (Fee does NOT APPLY to medicaid or medicare clients)
After 2 Missed Appointments, you will be discharged from practice and ineligible to book any future appointments.


NOTICE: Provider does NOT prescribe any controlled substances.
For assistance with booking or insurance verification, please contact office at (943) 888-1824.
All calls and messages sent at 5pm or later will be returned on the next business day.


 

Please specify upon booking, reason for appointment- DO NOT LEAVE BLANK. Doing so will result in appointment request denied.

 
Initial Psychiatric Evaluation MANDATORY for all new clients

All insurance must be submitted and verified at minimum x2 days prior to appointment. A photo copy of insurance card will be requested. Failure to provide insurance card or complete initial paper work x2 days prior to appointment will result in cancellation.
CURRENT CLIENTS ONLY: Medication refill or adjustment.