
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.
Helpful Forms
CLICK HERE to view and fill out forms for your appointment.
Make a non-refundable Payment
CLICK HERE to be taken to our secure payment page.