Suffix

Please tell us what type of services you are seeking. *

Therapy (Individual/Couples)

Medication Mangement (Telehealth only)

Both Therapy and Medication Management

Date of birth *

Individual or Couples Therapy? *

Before we get started collecting your information, is there any other message you have for us? If selecting couples therapy, please add your partner's name, email address and phone number below *

Address

Street Address *

City *

State *

Country

Postal Code *

Please select your type of Insurance Coverage. *

Commercial/Private Insurance

Medicaid (United Healthcare/Neighborhood Health Plan RI)

I do not have insurance coverage at this time.

Do you have Secondary Coverage?

Yes

No

Appointment Preferences

Please let us know your availability. We will do our best to schedule your appointment at a time convenient for you.

Messaging Consent

By providing your phone number, you agree to receive text messages from Arrow Behavioral Health. Message and data rates may apply. Message frequency varies. Reply STOP to opt out.