Edwards Psychiatric Care Send Message

Who would be receiving care?

Your info

Select the state you live in
Reason for care
Select the concern that best describes what you are seeking help with. You can provide more detail later in the prescreener.
Select the option that best describes what you are looking for. If you are unsure, choose “Not sure.”
Select the option that best describes your treatment history. Additional details can be provided later.
Example: Hydroxyzine 50mg daily
Administrative
How were you referred to my practice?
Billing & Payment
How do you plan to pay?
Client Preferences
For example: what you'd like to focus on, insurance or payment questions, etc.
Limited to 600 characters

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

By submitting this form, you agree to the processing of your sensitive personal information, which may include protected health information (PHI). This information may be viewed by team members in this practice. You also agree not to submit any payment information, including credit or debit card details, through this form.