top of page

Request Services

Please complete the form below in order to request an appointment. Completing the Form does not guarantee that you will be offered an appointment immediately. If no appointments are available, you will be added to our waiting list and contacted as soon as something becomes available.

Request an Appointment 

 

Note: Please be advised that all form submissions can only be completed by the Client themselves if they are 18 years and older or by a parent/guardian if under 18 years old. 

Please select one of the following:
arrow&v
Client's Availability for Appointents:
Please Select Client's Preference for Therapist Gender:
Does the client have mental health insurance coverage?

If the client is covered by insurance please complete the following information below:

Are you the primary insured:
arrow&v
By clicking SUBMIT below, I am aware that Resolution Point Behavioral Health only provides therapeutic services virtually and agree to receive services in this manner.
bottom of page