Request appointment | Renew Psychology - Rehabilitation and Neuropsychology Services LLC

Renew Psychology - Rehabilitation and Neuropsychology Services LLC

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Reason for care

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1 Appointment info

2 Prescreener

Reason for care

3 Contact information

Briefly describe why you are seeking services.

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What mental health treatment have you had (now or 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 in the past 12 months. Hospitalized for mental health reasons in the past. Attempted suicide in the past None of these apply

Have you been psychiatrically hospitalized any time in the past 12 months?

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Are you wanting services for any of the following problems:

[Check all that apply]

Suicidal thoughts or behavior Homicidal thoughts (i.e., wanting to hurt or kill others) Self harm (e.g., cutting, burning) Schizophrenia or psychosis (e.g., hallucinations, delusions) Bipolar Disorder (or "manic depression") Eating Disorder (e.g., Anorexia or Bulimia) Marriage therapy / Couples Counseling Needing a psychological assessment for legal problems (e.g., custody, lawsuits, court) ADHD or Autism Spectrum [assessment or treatment] Substance abuse (including alcohol, drugs, prescription medicine) Depression Anxiety (or Panic Attacks) PTSD Insomnia Pain Brain Injury (TBI, Stroke) Other medical problem

Have you been having serious suicidal thoughts in the past month (e.g., wanting to die, considering ways of ending your life)?

***If yes, please be aware of the following resources that could assist you with gaining faster access to care: Call or text "988" - the 24/7 national crisis line. Call 911 or go to your nearest emergency room if you fear you cannot keep yourself safe. You are worth being safe. You are worth getting better for.

Yes No

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

Renew Psychology - Rehabilitation and Neuropsychology Services PLLC

423.295.8335 |

Ooltewah, TN

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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.