Request a Consultation

Invest in yourself; See whether tele-psychiatry is a good fit for you, while safeguarding your personal information.

THREE STEPS

  1. Click on the “Get Started Now” button below

  2. Download the PDF form, saving it.

  3. Fill out the form with your info, complete the rest of the questionnaire & return completed form by email using your favorite PDF app or try the free PDFgear (https://www.pdfgear.com)