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Illustrative care scene.
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This is an initial inquiry, not a clinical assessment or a confirmation that services are available. Please do not include diagnoses, medical records, Social Security numbers, or insurance/member numbers.
This form is not monitored continuously. For time-sensitive scheduling needs, call (319) 320-2138. Office hours: Monday–Friday, 8:00 AM–5:00 PM.
Care has not been scheduled and no charges are agreed to by submitting an inquiry.
You can speak with us at any stage.
The questionnaire is optional. If you would rather discuss your needs directly, call our team.
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