New Patient Intake
Request an Appointment
Complete the form below and we'll reach out within one business day to confirm your appointment and answer any questions.
Before You Begin
- This form is for new patients only. Existing patients, please contact us directly.
- Appointments are telehealth by default. In-person visits are available by request and subject to provider approval.
- Mental Clarity Care does not provide emergency or crisis services. If you are in crisis, call or text 988.
New Patient Request
All fields marked with * are required.
Mental Clarity Care is not an emergency service. If you are experiencing a mental health crisis, please call or text 988 (Suicide & Crisis Lifeline) or go to your nearest emergency room.