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.
We are NOT accepting new patients with Aetna, Medicaid, EAP, or Tricare insurance at this time. **If you have a referral from Tricare or Humana, please reach out to them directly to inquire about a referral for an alternative healthcare provider.**
There are currently available slots for immediate appointments.
Appointments with interns are billed at a reduced *self-pay rate* of $40 for counseling services.
The Intake Coordinator will get back to you within 2 business days with available appointments.
We are NOT accepting new patients with Aetna, Medicaid, EAP, or Tricare insurance at this time. **If you have a referral from Tricare or Humana, please reach out to them directly to inquire about a referral for an alternative healthcare provider.**
There are currently available slots for immediate appointments.
Appointments with interns are billed at a reduced *self-pay rate* of $40 for counseling services.
**Please scroll up after submitting the New Patient Form to see a confirmation message**
| Informed Consent & NS Policy |
