Request appointment | Arzilence Psychiatry

Request an appointment

Referral source

Enter how you were referred to our services

Driver's license upload

Do not upload sensitive financial information such as credit card information.

Do you currently have a primary care provider?

For inquiries about a minor (prospective patient under 18)

Before continuing, please confirm the following:

I am the parent or legal guardian of the patient, or an adult with legal authority to seek psychiatric care on their behalf. I am completing this prescreener in the patient's presence and am answering on their behalf. I understand that identity verification at this stage uses my own government-issued photo ID. Verification of the patient's own identity will be required separately when their client portal is set up. I am willing and able to provide documentation of legal guardianship (custody order, adoption decree, or equivalent) if we request it. If we proceed to schedule an initial evaluation, I will attend the first visit in person with the patient. Not applicable (prospective patient is an adult)

For medical emergencies, contact your healthcare provider or call 911. For mental health crises, call or text 988.