Welcome new patients! Please complete the intake form below and click submit. The form below includes necessary information required for an initial patient intake. It is very important to complete the entire intake form so we may better serve you. A staff member will contact you within 24 hours or the next business day to discuss scheduling and treatment needs.
We are here to work with you!
Upon scheduling an initial appointment, the Bridges' staff will make every effort to meet the various needs of patients and provide quality care. Please notify staff of scheduling conflicts and we will attempt to accommodate your needs. If you are not satisfied with the services provided by the Bridges' staff upon the initial appointment; please notify the front staff and/or request a New Patient Survey. The Executive Director will contact you to assist in resolving the issue.
New Patient Information:
Please complete the information below as truthfully as possible. If a specific option or question does not apply to you, please enter N/A in the text box. All information that is entered will be kept strictly confidential.