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Will you be using insurance?
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Do you have any regularly scheduled conflicts?
Such as days or times you already have obligations.
Do you prefer appointments to be in-person or virtual?
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Prescribing medications requires an in-person session.
What services are you interested in?
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If you selected 'Other', please specify what other services you are looking for:
What are you looking to address regarding you mental health?
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We specialize in complex disorders, such as treatment-resistant depression, anxiety, PTSD, and bipolar.
Are you currently engaged in any mental health treatment?
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Please list any current medications you take, including psychiatric and medical medications, vitamins, supplements, etc.
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Have you had any inpatient mental health hospitalizations within the last three months?
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If you answered 'Yes', please provide more information:
Are you currently having suicidal thoughts?
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If you are having suicidal thoughts and there is immediate concern for your safety, please call or text 988 (Suicide and Crisis Lifeline).
Do you use any substances on a regular basis that you or anyone have considered to negatively impact your life?
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This includes alcohol, marijuana, amphetamines, cocaine, opiates
If you answered 'Yes', please provide more information:
Anything else you'd like me to know before following up with you?
How did you hear about Kathleen M. Noë, NP?
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Psychology Today
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If you selected 'Referral' or 'Other', please specify referral source:
