Request appointment | Innovations Psychiatry

What brings you to us?

For example: Depression, anxiety, difficulty with focus

Are you currently in danger of hurting yourself or others?

No Yes (Please do not complete this form. Dial 911 or go to the nearest emergency room)

Have you received mental health treatment in the past? If so, please list diagnosis if known, and any hospitalizations.

If this is your first time seeking care, write "No". If you can't remember details, that's OK.

Limited to 600 characters

Are you currently receiving any psychiatric care? If so, please specify.

Please note provider and type of treatment (medications, psychotherapy, TMS, etc)

What psychiatric medication are you taking now, if any?

Limited to 600 characters

For medical emergencies, contact your healthcare provider or call 911. For mental health crises, call or text 988.