Contact Us

Complete the form below and we’ll get back to you ASAP. We’re looking forward to serving you soon!

NOTICE:
We are phasing out email as we open up messaging on the patient portal.
Please message your provider through the patient portal.
Starting February 1, 2022 the email option will no longer be available.
To utilize the messaging feature within our Patient Portal, please click HERE
I'd like to reach...*
Schedule Directly on CareCloud

Don't have a CareCloud account? Request one here.
Request Your First Visit

If you've already sent the "Request Your First Visit" form above, continue below for any follow-up questions.
Pay Your Bill Online
Please use the TMS Contact Form or click here to learn about TMS.
Please use the Esketamine Contact Form
Release Information from MTC

If you've already sent the "Release Information" form above, continue below for any follow-up questions.
Use the link below if you need us to complete a disability or FMLA form.
Disability & FMLA Request

If you've already sent the Disability form above, continue below for any follow-up questions.
Got questions about scheduling, refills, or administrative matters? Please don't contact your provider about those (use the admin department above).

Is it a complex issue you're writing about? We may be able to give initial guidance, but it’s best to schedule an office visit or phone consultation as well.
Name*
Date of Birth*
MM slash DD slash YYYY
Phone*
Secondary Phone
Email*
Message*
Pharmacy Name
Pharmacy Phone
Medication Names*
List meds you need refilled or authorized. Tell us if you are taking them differently than prescribed.
If you've been off your medications for more than 3 days, let us know when you last took them. It may not be safe to restart at your old dose.
We'll get back to you by the next weekday for treatment issues. For emergencies, call our 24 hour line: (336) 525-9090
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Mailing Address

Mood Treatment Center
713 SW Marshall Street
Winston-Salem, NC 27101-5808

Complete the form below and we’ll get back to you ASAP. We’re looking forward to serving you soon!

Mailing Address

Phone/Text

Fax

Email

Our phone is staffed 7:00am-5:30pm Mon-Fri Urgent line (for current clients only): (336) 525-9090 Our urgent line is staffed 24/7

Our phone is staffed 7:00am-5:30pm Mon-Fri
Urgent line (for current clients only): (336) 525-9090
Our urgent line is staffed 24/7