UpWell New Client Inquiry

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Thank you for your interest in UpWell Psychiatry!

We have appointments available with our highly-trained Psychiatric Nurse Practitioners (PMHNPs) available within 1-2 weeks. We provide medication evaluation/management with brief therapy - completing this form is the fastest way to secure an appointment and to make sure we are a good fit for your goals.

We serve clients 14+ located in Oregon and Washington.

We don't provide therapy services without medication services.

We DO NOT provide 1st time ADHD diagnosis.

Privacy Policy: Our New Patient Form is HIPAA compliant (protects your information) and will never be shared with 3rd party. By providing my contact information to UpWell Psychiatry, I acknowledge and give my explicit consent to be contacted via email and/or SMS for the purposes of engaging in services.

Full Name *

Email *

Phone Number *

Date of birth *

YYYY

Current state of residence (we can only see clients located in Oregon or Washington) *

Oregon

Washington

Other:

I am interested in working with: *

First Available

Shannon La Douce, PMHNP

Megan Sapp, PMHNP, CNM, FNP

Katharine Frissora, PMHNP

Kelly Aldinger, PMHNP, MSW

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