booking | Brain Health USA

menu trigger menu trigger

Home
Services
- Child, Adolescents&Adult psychiatry
- Psychology
Care Team
For Patients
Telehealth
FAQ
Careers
Contact US

We accepts most insurance providers, including Medical and Medicare, for all your healthcare needs.

Patient Name *

First

Last

Date of Birth *

Cell Phone *

Email *

Patient's Gender

Male
Female
It doesn’t matter

How would you like to pay? *

Card
Insurance

Primary Insurance Provider *

Please type Self Pay if you don’t have any Insurance

Insurance ID *

Please type Self Pay if you don’t have any Insurance

What Service are you interested in? *

Psychiatry (Evaluation/ Medication Management)
Therapy (Individual/ Group/ Couple/ Family)
Both

Preferred Provider Gender *

Male
Female
It doesn’t matter

Preferred Appointment Time *

Morning
Afternoon
It doesn’t matter

Preferred Appointment Date

Comment

Name

Copyright by Brain Health USA 2019. All rights reserved.