GET STARTED Fill out our short intake questionnaire now to see if Shorelines would be a good fit for you. Step 1 of 6 16% What services are you looking for?(Required) Individual therapy Medication management Both I’m not sure Have you ever been in therapy or counseling before?(Required) Yes - Currently in therapy Yes - In the past, but not at the moment No Have you ever taken a mental health medication before?(Required) Yes - Currently on medication Yes - In the past, but not at the moment No What is the reason you’re seeking treatment? Help with…(Required) Anxiety Depression Eating Disorders Bipolar Disorder OCD Other I’m not sure Untitled Has your daily life been affected by any of the following symptoms?(Required) Trouble falling asleep or sleeping too much Not finding pleasure in tasks you used to enjoy Having trouble concentrating Eating too much or not enough Feelings of worthlessness or hopelessness Intrusive thoughts Feeling easily irritated or annoyed Trouble connecting with friends or loved ones Other None of the above Untitled(Required) It sounds like Shorelines Care could be a great fit for you. Fill out the form below and our team will reach out to schedule a consultation.Name(Required) First Last Email(Required) Phone number(Required)What state do you live inAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificWhat insurance do you have(Required)CignaUnited Health/OptumHometown HealthAetnaI don’t have insuranceOtherUntitled(Required) CAPTCHAPhoneThis field is for validation purposes and should be left unchanged.
