CONTACT US

Initial Intake FORM

If you are experiencing a mental health emergency please call 911 or consider one of the following recommendations:

  • If it is safe for you to drive, go to your nearest Medical Facility or Emergency Department.
  • Or call the National Suicide Prevention Hotline at 800-273-TALK, or
  • Triangle Springs 919-746-8900. They have 24 hour availability
  • Holly Hill Respond 919-255-7000. They also have after hours and weekend crisis coverage.
  • Monarch Wake Behavioral Health Urgent Care 919-703-2845. They provide same-day walk-in care Mon-Thu 8 am-8 pm, Friday 8 am-3 pm, and Saturdays 8 am-1 pm. Location: 319 Chapanoke Road, Suite 120, Raleigh, NC 27603
  • WakeMed Mental Health & Well-Being Hospital 919-350-8000 Location: 111 Sunnybrook Rd, Raleigh NC 27610

Initial Intake Form / New Patient

Please fill out this form in its entirety, and we will be in touch as soon as possible.