Please complete the form below. Your information will be securely sent to our team, and we’ll contact you within 24 business hours.
Prefer to speak to someone on the phone? Call our Patient Care Representatives Monday–Friday, 8:00am–5:30pm at 833-278-4357.
Immediate or Crisis Support
If this is a medical or mental health emergency where you feel you’re in physical danger, call 911.
If you’re having a mental health or substance use crisis and need support, call or text 988.
Branch Contact
For urgent branch needs, visit our Locations page for direct numbers.
Insurance & Payment
We accept Apple Health/Medicaid, many commercial insurance plans, and offer a sliding-fee scale based on income.
Important Note
After you submit the form, we’ll call or email you as soon as possible. Calls may appear as Restricted. Please make sure your phone number and email are correct so we can reach you.
