Release and Renew Mental Wellness

Psychiatry | Therapy | Genesight Testing | Neurofeedback | Integrative Wellness

Maryland, Delaware, Florida, and Connecticut

Children, Teens, and Adults

Our Services

New Client/Patient Pre-Intake Form

A beige linen napkin, a sprig of green leaves, and a greeting card with the words 'EASE' and 'slow days heal' on a decorative tray with string lights.

Compassionate Mental Health Care for Children, Adolescents, & Adults

Thank you for your interest in Release and Renew Mental Wellness. Our practice provides comprehensive psychiatric evaluation, medication management, therapy, and integrative mental health services.

To begin the process of becoming a client/patient, please complete the Pre-Intake form below. This information helps our team determine the most appropriate services and provider for your needs.

Once your request is received, our team will review your submission and follow up within 2–3 business days regarding scheduling and next steps.

After submitting this form:

  1. Our team will review your information.

  2. If appropriate for care, you will receive instructions via your preferred method listed in the form to schedule a New Patient Intake Appointment.

  3. Additional intake paperwork may be sent through the client/patient portal once you are accepted.

Please allow 1–3 business days for review.

Pre Intake Form