Upper Darby Township, PA +1 (267) 939-3119
24/7 Lifeline: Call/Text 988 Contact

Book an Appointment

Let’s find the right time to talk

Tell us a little about what you’re looking for. A care coordinator will call or email you back within one business day to confirm a time — no obligation, and nothing is scheduled until you say yes.

Most intakes booked in 24–48 hours Telehealth or in-person Confidential & HIPAA-compliant

Thank you — your request is in.

A care coordinator will contact you within one business day. If you need support sooner, call +1 (267) 939-3119.

1 Who is this appointment for?
2 What kind of support?
Please choose a service, or select “I’m not sure yet”.
3 When suits you?

We’ll do our best — we’ll confirm the exact time with you.

4 How can we reach you?
Please enter your first name.
Please enter your last name.
Please enter a valid email address.
Please enter a phone number we can reach you on.
5 Anything else?

Please don’t include detailed medical information here. We’ll gather that securely during your intake.

We need your consent before we can contact you.

Submitting this form does not create a clinician–client relationship. If this is an emergency, call 911 or the 988 Lifeline.

What Happens Next

From request to first session

1

You send this form

It takes about two minutes. No payment details needed.

2

We call you back

Within one business day, at the time of day you chose.

3

Short intake chat

We talk through your goals and confirm insurance or payment.

4

Your first session

Matched with a clinician, at a time that works for you.