Request an Appointment

There is no obligation. Send this request any time and a member of our team responds within one business day to confirm your insurance and find a time that works. If we are not the right fit for what you need, we will tell you and point you toward someone who is.

We respond within one business day.

If this is an emergency, call 911. For a mental health crisis, call or text 988, or text HOME to 741741.This form is for scheduling only. Please do not include symptoms, diagnoses, medications, your Social Security number, or date of birth. We'll gather clinical information securely once your appointment is scheduled.

Full name

Phone

Preferred contact method

Are you a new or existing patient?

Service of interest

Insurance carrier

Preferred provider (optional)

Best time to reach you

Anything you'd like us to know (please don't include medical details)

I agree to receive text messages from Louisville Behavioral Health Systems, PLLC about scheduling. Message and data rates may apply; reply STOP to opt out. Consent is not required to receive care, and we will never text medical details. See Text Messaging Terms.

Prefer to talk? Call (502) 454-8800.

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