Patient Intake Forms

This will help us get to know you to make sure we can best meet your needs — you will get an email back within 24 hours so you can request an appointment time!

Privacy Policy: Our Contact Forms are HIPAA compliant (protect your information) and will never be shared with 3rd party.

By providing your contact information to UpWell Psychiatry, you give your consent to be contacted via email and/or SMS for the purposes of engaging in services. Message and Data Rates may apply, and you may request an end to communication at anytime.

We want you to get the support you deserve.


Virtual throughout Oregon & Washington States



Intersted In More Helpful Content? Sign Up For Our Newsletter Here!