Request an Appointment

Fill out the form below to request and appointment with the Doctor.

For Emergencies: Call (334) 280-3230

Step 1: Complete Patient Forms

In order to schedule a session with one of the clinicians, please fill out the patient forms first. 

Please fill out the New Patient Intake Questionnaire and the Consent for Treatment form.

Then, as a final step, complete the form at the bottom of this page to schedule your session.

New Patient Forms

New Patient Questionnaire

Click below to fill out the form if you’re a new patient

Consent For Treatment

Click below to fill out the consent for treatment form

HIPAA Authorization Form

Click below to fill out the HIPPA Authorization form

Release of Medical Records

Click below to fill out the release of medical records form

Fill Out The Form

Or call — 334-280-3230

Better Mental Health is Our Mission

Personal Care. Personal Health.

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Helpful Forms

CLICK HERE to view and fill out forms for your appointment.

Make a Payment

CLICK HERE to be taken to our secure payment page.

cp@drcpalmer.com

RW@drcpalmer.com

3090 Woodly Road Montgomery, AL 36116

(334) 280-3230