Reaching out for support is a crucial first step in your journey toward healing.

Example: 1234 Chicago Ave, Chicago, IL 60606

To expedite the insurance verification process, kindly provide the following documentation:

Important: If you select any “Yes” response, please discontinue this form immediately and call 911 or go to the nearest Emergency Department for further evaluation and management. Our clinic does not provide treatment for psychiatric emergencies. Once you are stabilized and no longer experiencing active thoughts of suicide, homicide, or harmful hallucinations, we would be glad to see you for outpatient care. Your safety matters.

Important: If you select “Yes,” we understand that seeking the proper care can be challenging. We encourage you to consult your insurance provider’s directory to find a dual diagnosis or addiction-specialized clinician who can offer comprehensive and coordinated support. As our clinic specializes in other areas of psychiatry, we regret that we are unable to accept your case at this time.

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At your convenience, you may send a HIPAA-secure short text via the Spruce app to request an appointment or for general administrative inquiries about our clinic, clinical services, and fees only.

Disclaimer: All electronic communications, including HIPAA-compliant text messages or calls, the contact form on this website, clinic email, and social media interactions, are intended exclusively for general administrative inquiries only. Such inquiries include requests for appointment availability, the providers’ specialties, whether a new patient would be a good candidate for the clinic, clinical service fees, other practice management questions, and mental health awareness promotion. Electronic communications do not replace any form of psychiatric evaluation and they do not establish a patient-provider relationship. Therefore, please do not provide any personal, sensitive, or confidential information and/or any medical or psychiatric records beyond that which you feel comfortable disclosing. For established patients, please contact your provider via the patient portal.

BE WELL, BE YOU ®

BE WELL, BE YOU ®

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