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Request documents for electronic signature.
Please request forms at least 48 hours prior to appointment. Documents must be signed at least 12 hours prior to the appointment to allow for routing to appropriate clinician.
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Last
Phone Number
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Email
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Services Requested
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Individual Counseling
Couple Counseling
Family Counseling
Neurotherapy
Rehabilitative Mental Health (PSR/BST)
Emotional Support Pet Evaluation
Select all services you are interested in.
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Home
Services
Referral
Counseling
Emotional Support Pets
Rehabilitation Services
Neurofeedback
Homecoming for Veterans
Purchase Services
Resources
Patient Registration
Crisis
Form Downloads
Links
Request Records
Internship Application
Schedule
Contact Us