Please fill out this online intake form to start the appointment process and our office will follow up with you in 24 to 48 hours. In case of an emergency, please call 911.

Our online intake form is confidential and secure. It is sent directly to a password protected and encrypted server. We do not sell, rent or otherwise disclose personal information collected by our site to any third parties. Your data is for intake purposes only and is only accessible by designated administration staff. If you have any questions, please call 412-366-1300.