If you would like to schedule an appointment, please complete the form by clicking the CONTACT link.

Please answer all questions completely and upload your current insurance information, including your insurance card, so that we can verify your benefits on your behalf. If you are not using insurance, please enter N/A where applicable.

If you plan to use an Employee Assistance Program (EAP), you must also provide your EAP authorization number.

We are unable to schedule an appointment until all required information has been received. Once your completed form and insurance or EAP information are submitted, our team will review your request and someone will contact you within 48 hours.