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New Patient

Information 

OUR PRACTICE IS CURRENTLY FULL.
WE ARE NOT ACCEPTING
NEW PATIENTS AT THIS TIME.

Complete this form
to be on our waitlist

To schedule an initial session, we’ll need some basic information. This is to make sure that our practice is in-network if you want to use insurance. Fill out the form below to get started.

If you have been a prior patient but are not currently active, we’ll need to re-enroll you.

I am a
I will be using insurance as part of my payment
Are you looking for help with any of the following?

Thanks for submitting!

FOR EMERGENCIES IMMEDIATELY CALL 911 OR GO TO THE NEAREST EMERGENCY ROOM

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