Request appointment | 1 Alliance Counseling & Psychotherapy Services

1 Alliance Counseling & Psychotherapy Services

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Reason for care

Select date & time

1 Appointment info

2 Prescreener

Reason for care

3 Contact information

What is the reason for seeking care?

Please note we do not work with Eating Disorders at this practice as it is best to seek specialized care.

Anxiety Attentional difficulties Behavioral issues Depression Grief Relationship issues Substance use Trauma Work Stress Other

What kind of care is being sought?

Psychotherapy (Talk Therapy - Counseling) Medication Management Other Not sure Both Medication Management and Psychotherapy

What mental health concerns or treatment have occurred in the past?

In therapy now In therapy in the past Taking psychiatric medication now Taken psychiatric medication in the past Hospitalized for mental health reasons now or recently Hospitalized for mental health reasons in the past Known neurologic or genetic disorder Attempted suicide in the past None of these apply

Are you currently applying or on FMLA or/ and Disability?

Mark all options that apply. Note, FMLA - Family medical leave act. Disability such as short term disability, long term disability (private or government))

Applying for FMLA Currently on FMLA Applying for Short Term Disability Currently on Short Term Disability Applying for Long term Disability Currently on Long term Disability

For medical emergencies, contact your healthcare provider or call 911. For mental health crises, call or text 988.

1 Alliance Counseling & Psychotherapy Services

678.310.6631 |

Alpharetta

Main Location

5755 North Point Pkwy, Suite 101
Alpharetta, GA 30022-1152

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THE CLIENT PORTAL IS NOT TO BE USED FOR EMERGENCY SITUATIONS. IF YOU OR OTHERS ARE IN IMMEDIATE DANGER OR EXPERIENCING A MEDICAL EMERGENCY, CALL 911 IMMEDIATELY.