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Who would be receiving care?

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For insurance verification
Select the state you live in
Reason for care
**For Minors, please enter minor as the primary client and parent/legal guardian as contact. **
Administrative
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Please enter your contact preference below. We will respond to your inquiry via email by default. If you would prefer a callback, please use the link provided to schedule a 10min to 15min call that works best for you at https://calendly.com/nperfectbalance-support/
Billing & Payment
To help us prepare for your appointment: For Insurance/EAP Clients, please upload a clear photo of your insurance card or EAP authorization. For Military/Tricare, please upload your Military ID front and back. Self-Pay & Inquires only, please upload a blank image to proceed. If you have any questions, we’re happy to assist.
Upload a photo of your insurance card
Client Preferences
Note: Consultations are 15mins in length
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Please You have selected to schedule with your preferred clinician. Please select an alternate clinician below in case your first choice is unavailable. To learn more about each clinician, please visit: https://nperfectbalance.com/our-team
If timing is your priority, please select alternate clinician(s) in case your first choice is unavailable. This will help us schedule your appointment as quickly as possible. You can learn more about each clinician here: https://nperfectbalance.com/our-team

For medical emergencies, contact your healthcare provider or call 911. For mental health crises, call or text 988.

By submitting this form, you agree to the processing of your sensitive personal information, which may include protected health information (PHI). This information may be viewed by team members in this practice. You also agree not to submit any payment information, including credit or debit card details, through this form.