Complete your intake forms
Filling this out before your visit means we can verify your insurance and review your history ahead of time — so your first appointment is spent on your treatment, not paperwork. It takes about five minutes.
Where your information goes
The form above is hosted by SimplePractice, our HIPAA-covered patient-records system, and is protected by a business associate agreement. Your answers go straight there — they are never stored on this website. Records of treatment for substance use are also protected by 42 CFR Part 2, a federal confidentiality rule that is stricter than HIPAA.
What happens next
- You complete the form above. Basic contact details, what you're looking for help with, and your insurance.
- We review it and confirm a time. A person reads every request. If the time you asked for isn't open, we'll offer real alternatives.
- You get portal access. Once you're set up as a patient, your consent forms and remaining paperwork appear in the secure portal to sign electronically.
- You get a link for your video visit. Every appointment is 100% virtual — no waiting room, no drive.
Already a patient?
If you've been seen before or already have portal access, sign in to complete or update your documents. For your security the portal opens in its own window rather than inside this page.
This form is not monitored around the clock
It is not an emergency service. For a medical emergency or overdose call 911. For a mental-health or suicide crisis call or text 988. For free, confidential treatment referrals 24/7, call SAMHSA at 1-800-662-HELP (4357).
Ready when you are
Same-day appointments are available. Every visit is 100% virtual — one video call is all it takes to get started.
Confidential · 100% virtual · NC Medicaid accepted · Serving all 100 North Carolina counties.