Thank you for choosing Mental Health Baltimore. We are a hybrid organization offering telehealth and limited in-person visits!
Note: Your privacy is important to us. The information you share with us on this form will be kept confidential and part of your protected health information (PHI).
Complete Our New Patient Intake Below!
3 easy steps. In step 1 complete the the registration form for your age group. Step 2 complete the treatment consent form for your age group and the telehealth consent form. Step 3 schedule your initial video-visit appointment. Whats needed? A smart phone, desktop, laptop or tablet, a cell phone number, email address and a good internet connection!
Become a New Patient: It’s As Easy As 1-2-3
We are delighted to welcome you to our practice and appreciate the trust you place in us to manage your healthcare. To make the process as seamless as possible, we have streamlined it into three simple steps.
Complete New Patient Registration
To initiate your journey with us, the first step is to complete the new patient registration. This will give us some basic information about you, including your name, contact details, emergency contact, and medical history.Adult New Patient Pediatric New Patient
Complete Patient Consent Forms
The next step involves granting us necessary permissions for your care. Treatment Consent Form: This essential form provides us your agreement for you or your child’s healthcare and treatment plan. Telehealth Consent Form: With this, you enable us to incorporate remote telehealth services into your or your child’s healthcare.Adult Consent Form Pediatric Consent Form Telehealth Consent Form
Schedule New Patient Appointment
Now that we have your registration and consent forms, the next step is to schedule your first appointment. You can use our online scheduler to select a date and time that works best for you.Schedule time with me