Contact | One Twenty-Four Psychiatry & Wellness

Looking forward to meeting you

For new patients requesting an appointment, click the button below to fill out a new patient inquiry form. If you are asking about rates, see here.

In person medication and therapy appointments are available at our office in Sandy Springs, GA.

Telehealth sessions are available to Georgia and Vermont residents.

Coaching services are available nationwide.

Please note that we treat these forms the same way that we do all patient charts- with the utmost respect to patient privacy. Your information will only be accessed by the applicable clinical and administrative staff that will be communicating with you.

If you experiencing a medical emergency please do not complete this form. Seek emergency services. You can call 911 or the crisis help line at 988.

First name

Last name

Age

Please add your address. This is used to ensure you are located in GA or VT as these are the only states we currently operate in.

Address

Phone

Can you tell me a bit more about your history and why you are looking for a mental health clinician?

What services were you interested in?

Check the box to acknowlede that this practice does not prescribe stimulants, opiates, or any other controlled substances.

This is a checkbox to acknowledge that this is a private pay practice

Looking forward to meeting you

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