Request a Free 10min Consult

Emergency Assistance

If this is an emergency, call:

911
Suicide hotline: 988

Client Information

First name

Last name

Email address

Phone number

I'm already a client

Preferred Time

Date

Tuesday, Wednesday, Thursday

Time

8:30am; 3:45pm; 4:45pm; 6pm

Policy

I understand that this is a free 10min consultation by phone. Appointments will be conducted virtually (via telemedicine).

Yes, I understand that payment for my appointments are expected at the time of each visit and can be paid via credit card or health flexible spending account card.

Yes, I understand that Discreet Medical, PC does not accept or participate with any health insurance company, but I will be provided a super bill to submit to my health insurance company. If I have out-of-network benefits, and I submit the super bill to my health insurance company, I may receive partial reimbursement for each visit.

Yes, I understand that Discreet Medical, PC does not participate in Medicare or Medicaid.

Reason for consult

I am new to psychaitry

I am not new to psychiatry

I am interested in psychiatry and psychodermatology and/or psycho-oncology

I am a referring provider

Additional Information

Please include anything you feel is pertinant

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Request a Free 10min Consult

Emergency Assistance

Client Information

Preferred Time

Policy

Emergency Assistance

Erika Balfour, MD