Getting Started

If you would like to apply for treatment at our clinic please call 212-838-4333,ext. 137 to schedule an intake appointment. Individuals may contact the Clinic on their own or may be referred by family members, doctors, and other health professionals, schools, or social and health agencies.

Please ensure completion of the following before our appointment. Provide as much information as possible. The application and accompanying forms must be submitted no later than 48 HOURS PRIOR to the scheduled intake appointment. Failure to do so will result in rescheduling the session.

Our admission process begins with a phone screen conducted by our Intake Coordinator. An initial interview is then scheduled. Subsequently, an Adult Services Application or Child and Adolescent Services Application (for those younger than 18 years of age) is completed.

Step 1: Please select either the Adult or Child application for therapy, by clicking on either of these links:

• Adult Services Application
• Child/Adolescent Services Application

Once you have completed the initial application form, you will be directed to each of the following forms in turn:

• Step 2: Patient Consent for Limited Email and Text Communications:
• Step 3: PSYCKES Consent
• Step 4: Healthix Consent
• Step 5: Medical Form Self Report *
• Step 6: Medical History & Physical Examination – To Be Completed by Physician *
• Step 7: Consent Form/Authorization For Release of Information (if applicable)
• Step 8: Services Agreement
• Step 9: Final Step: with access to Notice of Privacy Practices, Patients Rights and Cancellation and Missed Session Policy

* For these 2 forms, you may choose to download and print a PDF to be completed off-line. Once downloading the PDF, select “Skip to the next form” to continue on.

Once you have completed ALL these forms, we will conduct the initial interview that generally takes place with our Intake Coordinator. The initial interview is often a one-on-one interview with the applicant, but if appropriate, family members and other important people in the applicant’s life may be included. Applicants receive a thorough mental health evaluation, including a psycho-social history, psychiatric interview and/or psychological evaluation, if necessary.

After the initial interview each case is reviewed by the Admissions Committee to determine whether therapy at the Clinic would be beneficial. Patients are then generally assigned to therapists within a few days. Most patients are assigned to some form of individual treatment including counseling, supportive psychotherapy, psychoanalytic therapy or psychoanalysis. Psychopharmacological therapy is also available for patients receiving psychotherapy. Each individual’s treatment is characterized by an intensely personalized approach, greatly increasing the probability of successful results.