To request an appointment, please fill out one of the following forms: New Patient Appointment New Patient AppointmentFirst Name Last Name Date of Birth: Phone Number AddressAddress Line 1 Address Line 2 City State Zip Code Country Select CountryAfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelauBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongo (Brazzaville)Congo (Kinshasa)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao S.A.R., ChinaMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussiaRwandaSão Tomé and PríncipeSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (Dutch part)Saint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia/Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom (UK)United States (US)United States (US) Minor Outlying IslandsUnited States (US) Virgin IslandsUruguayUzbekistanVanuatuVaticanVenezuelaVietnamWallis and FutunaWestern SaharaYemenZambiaZimbabweEmail What kind of treatment are you seeking? – Select –Medication ManagementIndividual CounselingCouple CounselingFamily CounselingSubstance Abuse TreatmentOtherIf Other, please describe here: Insurance Carrier & ID Number: Are You Currently on Medication? Yes NoIf Yes, Please List Them Here If 18 Or Older: Are You Currently On Any Benzodiazepines? If yes, please note our provider does not prescribe these medications. To establish treatment, you need to be willing to taper off gradually or come off of it. Some examples of Benzos are Ativan (Lorazepam), Xanax (Alprazolam), Valium (Diazepam), Klonopin (Clonazepam) Yes NoJourneys in Mental Health & Wellness will not fill out, nor provide any disability or other forms for new patients. Patients should have at least 6 established visits in order to have any paper work fill out by the provider. Do you agree? Yes NoJourneys in Mental Health & Wellness does not provide any animal emotional support letters. Do you agree? Yes NoWhat is the best date and time to contact you? Brief details of reason for appointment: Submit Form Established Patient Appointment Established Patient AppointmentFirst Name Last Name Date of Birth: Phone Number Email What type of appointment are you interested in scheduling? – Select –Medication ManagementIndividual CounselingCouple CounselingFamily CounselingSubstance Abuse TreatmentOtherWhich provider did you need to schedule an appointment with? – Select –Carissa BerryChristine SandeFakira BerryMagen HenleyNicole BrookerRegina HalesSolana SparksWhat is the best date and time to contact you? Brief details of reason for appointment: Submit Form
CALL NOW