Request appointment | Pelican Behavioral Health

Request an appointment

What is the reason for seeking care?

(Example: anxiety, mood changes, difficulty sleeping, medication concerns, etc.)

Limited to 600 characters

What are your main concerns or goals for treatment right now?

Limited to 600 characters

How many times have you been hospitalized for psychiatric treatment?

Do you currently struggle with an eating disorder?

(Example: anxiety, mood changes, difficulty sleeping, medication concerns, etc.)

Are you experiencing unmanaged or severe chronic pain?

Are you in a romantic relationship (married, partnered, dating, or living together) with someone who is currently a patient at Pelican Behavioral Health?

Are you an immediate family member (parent, child, or sibling) of someone who is currently a patient at Pelican Behavioral Health?

Is there anything else important that you would like us to know?

For example: what you'd like to focus on, insurance or payment questions, etc.

Limited to 600 characters

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