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North Shore Counseling

New patients

Start with a short form

Four steps, about two minutes. Susan will use this to contact you and set up your first appointment.

Step 1 of 4

About you

How would you like Susan to contact you?

For example: weekday mornings, or after 5pm.

Step 2 of 4

Your appointment

Who is the appointment for?
How would you like to meet?
Which office is easiest for you? (optional)

Only needed for in-person appointments.

When are you usually available? (optional)

Check all that apply.

Step 3 of 4

Insurance

Just the company name, for example Aetna or Cigna. Do not enter your member ID.

Step 4 of 4

Send your form

Scheduling details only. Please do not include health details — you will talk about those privately with Susan.

After you press the button, this page will confirm that your form was sent.