Headlight Mental Healthcare - OR
All fields are required
Type of Visit
Initial Consult in Office - 60 min
Initial Consult Telehealth - 60 min
Initial Consult in Office -120
Initial Consult Telehealth - 120 min
Autism Eval in Office - 240
Autism Eval Telehealth - 240
Gender Affirming Eval 120
Gender Affirming Eval Telehealth - 120
Genomic Review in Office - 60 min
Genomic Review Telehealth - 60 min
Follow up in Office - 30 min
Follow up Telehealth - 30 min
Follow up in Office - 50 min
Follow up Telehealth - 50 min
Follow up Extended Telehealth - 120 min
Office
Headlight Mental Healthcare - OR
Reason for Visit
e.g. Initial Consultation
Patient name
Firstname Lastname
Date of birth
mm/dd/yyyy
Email
email@example.com
Home phone
(555) 555-5555
Cell phone
(555) 555-5555
Requested time
Select a time below under Available Times
Office Address:
555 SE MLK Blvd Unit 105 Portland OR 97214-2595
555 SE MLK Blvd Unit 105 Portland OR 97214-2595
New and Existing patients can make appointments online.
Office Phone:
+1 541-581-1080
You must select a date and time for your appointment.
Available Times
Previous Week
Next Week
Visit Length:
60 minutes
Submit Appointment Request
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