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Accepting New
Patients

Please print and complete the forms below prior to your appointment. You may also email completed forms to "scheduling@permamentalhealth.net"

New Patient Form (Adult)

New Patient Form (Child)

Counseling Consent Form 

Ready to Schedule?

Please fill the in form Below

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Thank you for submitting your request to schedule. We will contact you as soon as we recieve your request.

Please remember to call your health
insurance to verify coverage, eligibility, deductibles, and patient responsibility. 

*Please call your preferred office to verify your insurance 

Thank you for choosing PERMA Mental Health for your health care needs.  Please fill in the form to your right. Once the form is submitted someone from our Scheduling team will contact you to schedule your appointment.