Request an appointment.

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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Disclaimer: Please note that we do not provide emergency care. If you are having thoughts to imminently hurt yourself or anybody else, please call 911 or go to your nearest emergency room. We additionally recommend calling/texting the national suicide hotline at 988 for a psychiatric crisis.

BE WELL, BE YOU ®

BE WELL, BE YOU ®

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