Contact

Getting started with us is easy!

Fill out our contact form (below) or Intake form (See New patients page)
You will be contacted to gather more information if needed.
After review, we will contact you to schedule an appointment or make appropriate referrals.
Attend Your Session: Meet with our psychiatrist via our secure video platform.

Contact Form

Contact us

First Name *

Middle Initial

Last Name *

Date of Birth *

Gender

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Female

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Male

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Non-Binary

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Marital Status

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Single *

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Married

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Street Address

City:

State:

Zip Code:

Mobile phone:

Work Phone:

Email:

1. By checking this box, I consent to receive SMS text message to my cell number provided above
for notifications and alerts from Sozo Healthy Minds.

I understand that I am not required to provide my consent as a condition of purchasing any products or services.

I understand that I can opt-out of receiving text messages at any time by responding with STOP. I can reply with HELP to get help. Message frequency may vary.

I understand that message and data rates may
apply depending on my mobile carrier and that T-Mobile and other mobile carriers are not liable for delayed or undelivered messages. See Sozo Healthy Minds; Terms of Service [OfficePolicies] and Privacy Policy.

Agree

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I do not agree

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2. What problem are you dealing with that's led you to reach out for help?

3. What are you hoping to get out of treatment ?

4. Are you seeking disability or FMLA forms during your first visit?

"Thanks for reaching out to Sozo Healthy Minds. We will get back to you within 1-2 business days. If you or a loved one is in immediate danger or experiencing a psychiatric emergency, please call 911 or go to the nearest emergency room. This form is not monitored for urgent concerns."