Thank you for completing this registration form. The more information we have, the faster we can get you scheduled.
Payment & Insurance
If you don't see your insurance below, we are probably out-of-network. If that's the case, select "Private Pay." We can still submit bills for out-of-network benefits, however, you would need to pay the full rate at the time of service.
Mental health benefits can be tricky to navigate, but we will do some of that for you. All we need is the front and back of your insurance card. Most clients take a digital photo and upload it below.
If that doesn't work, you can email your card to [email protected]
, fax to 336-201-0538, mail to MTC New Patients / 713 Marshall St SW, Winston-Salem, NC 27101, or text it to 336-722-7266.
Call or text us at (336) 722-7266 as soon as you have finished this form. We can usually get you seen within 2 business days.
All of our therapists work with anxiety, depression, bipolar, and relationships. A few of our therapists have additional training in specialized areas, please let us know if you are looking for that.
Below are group therapies we offer throughout the year. We'll let you know when a group with you interests opens up.