Request an Appointment

If you are in crisis or experiencing thoughts of suicide; thoughts of harm to self or others;
unusual or erratic behavior or moods, please call CRISIS now at 800-560-4038.

Please Read Before Making an Appointment Request

All fields below marked with an asterisk (*) are required.

1.Choose Date and Time to Visit

Date you select from the calendar:

Now select a  minute or larger appointment time range between and

2.Tell us the Reason and how to contact you

3.Provide Referral Information (optional)

4.Add Notes and Review Your Request

Review Appointment Request:

Time Range:
Contact Phone:

You will not be able to edit this appointment once it is submitted. You can cancel the appointment and create a new one in the "Upcoming" appointments section.

Upcoming Appointment

Please keep in mind that any appointment information display here has been confirmed. Please mark your calendar. We recommend you come prepared and arrive at least 15 minutes before the appointment time to check-in. If you want to cancel or change the appointment, you can contact your doctor.

Pending Appointment Request

Your appointment request(s) listed here are waiting for confirmation. Please allow some time to process; you can cancel it/them at any time. If you don’t have any request listed here and you are planning a visit, you can go to the "New Request" section at any time.

Appointment History

All of your past appointment information is listed here. You can search by "Date" to find a specific appointment record. Some appointments are associated with report(s) that you can open to view. Other appointments don’t have reports. You can also see your past appointment status from the "Status" icon.

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