If you would like to be a new patient, please fill out and submit the form below. All information being transmitted is secure or confidential.

Please digitally sign below to signify that:

For addiction treatment, we do not accept checks at the first appointment.


Office staff cannot guarantee that a specific medication will be prescribed. Requests for specific medications must be made directly to clinical staff.


If you will be out of medications prior to your appointment with a prescribing staff, you must contact your prior psychiatrist/primary care physician for a refill.


Intake appointments may be cancelled if prior medical/counseling records are not provided before or at the time of the intake appointment.