Concierge Behavioral Health Program Sign-Up
In order to get started with Well's Concierge Behavioral Health program, we need a few details from you! Please fill out the following form to schedule your initial appointment with our digital care coordinator. You will receive instructions via email to create an account in our patient portal prior to your appointment with the digital care coordinator along with a Welcome Packet that must be completed prior to the call. If you have any questions prior to getting started, please reach out to the Well team at care@wellonline.com or call us at 858-381-3535. We are happy to assist!
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First Name *
Last Name *
Date of Birth *
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Phone Number *
Email Address *
Well currently provides concierge behavioral health services to patients in California. Are you a California resident? *
What days of the week work best for your initial phone consultation with a Well psychologist? *
Required
Is there anything you'd like our team to know before getting started?
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