New Patient Intake Form

​To start the intake process, please fill out the form below. The Intake Coordinator will get back to you within 2 business days with available appointments. ​
​Waiting List
Sykesville & Eldersburg
10-12 week waiting list for patients under 12 y/o
Westminster
4-5 month waiting list for all availability 
Updated 08/03/2020

Your First Visit in Office
Please complete all 6 documents below

New Patient Information
File Size:	132 kb
File Type:	pdf

Download File

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Minor Patient (If patient is under 18 y/o)
File Size:	111 kb
File Type:	pdf

Download File

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In Office Informed Consent
File Size:	130 kb
File Type:	pdf

Download File

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Technology Consent Form
File Size:	116 kb
File Type:	pdf

Download File

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Credit Authorization Form
File Size:	162 kb
File Type:	pdf

Download File

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COVID-19 Informed Consent
File Size:	110 kb
File Type:	pdf

Download File

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Telehealth Paperwork 

Telehealth Informed Consent
File Size:	124 kb
File Type:	pdf

Download File

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Other Paperwork 

Consent for Animal Assisted Therapy
File Size:	89 kb
File Type:	pdf

Download File

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Release of Information
File Size:	95 kb
File Type:	pdf

Download File

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Email address: 
Info@AnchorCounselingCenters.com

​​Phone Number:
443-328-4946
​Fax Number:
410-875-7687
​