Psychiatric Pre-Intake Screening Form

This brief form helps us better understand your current needs and determine whether Conscious Collective’s psychiatric services are the right clinical fit at this time. Your responses allow our team to review important clinical information before scheduling so we can support safe, appropriate care.

Please note: Completing this form does not guarantee psychiatric services or medication management. If your needs fall outside our current scope of care, we will do our best to guide you toward a more appropriate level of support.

If you are experiencing a medical or psychiatric emergency, or if you feel you may harm yourself or someone else, please call 911, go to the nearest emergency room, or call/text 988 for immediate support.