Skip to content
New Patient Form
Returning Patient
Home
About
Antidepressants & Depression Treatment
Mental Health Clinic in Seattle
Psychiatrist in Seattle
Bipolar Meds & Medication Management
Fees
Contact
Menu
Home
About
Antidepressants & Depression Treatment
Mental Health Clinic in Seattle
Psychiatrist in Seattle
Bipolar Meds & Medication Management
Fees
Contact
Text or Call to Setup an Appointment
206-607-9205
Home
About
Antidepressants & Depression Treatment
Mental Health Clinic in Seattle
Psychiatrist in Seattle
Bipolar Meds & Medication Management
Fees
Contact
Menu
Home
About
Antidepressants & Depression Treatment
Mental Health Clinic in Seattle
Psychiatrist in Seattle
Bipolar Meds & Medication Management
Fees
Contact
Text or Call to Setup an Appointment
206-607-9205
New Client Intake Form
We look forward to serving you. We will review your information, and contact you regarding our availability for accepting new patients within 48 hours. Note, submission of this form does not guarantee service, as we may be unable to take on new patients at this time.
First Name
*
Last Name
*
Your Email
*
I consent to receive email regarding appointments, billing and other non-clinical information from Grey Matters Mental Health Clinic, PLLC.
Your Phone Number
*
I consent to receive text regarding appointments, billing and other non-clinical information from Grey Matters Mental Health Clinic, PLLC.
What's going on?
*
(i.e., Depression, Anxiety, PTSD, etc)
What medications do you take?
*
Medication / Dose / Frequency
CAPTCHA