Get Started

Submit Intake Form

Please take a few minutes to complete our secure Intake Form below, which includes essential details like demographics, insurance, and any relevant psychological evaluations for your child. The form is HIPAA-compliant and will be reviewed by our Intake Team once submitted.

Fill Out Intake Form

What to Expect During Our Intake Process

You Will Hear From Our Intake Team

Following your intake form submission, you can expect to hear from a member of our Intake Team within 24 hours. We will reach out via email, phone, and text message to discuss next steps. During this conversation, we will confirm the details on your intake form, review insurance information, and assess availability for services. Don’t hesitate to ask questions. Our team is here to assist you and your family!

If you don’t see our communication in your inbox, please check your spam folder.

Submit Necessary Information

To expedite the intake process, you can send the following information to our Intake Team at intake@surpassbh.com prior to your conversation.
  • Front & back photos of your insurance cards
  • A copy of your child’s full psychological evaluation (if applicable)

Start Your Intake Form Today​

At Surpass Behavioral Health, we aim to make your experience smooth and seamless. We look forward to supporting you and your family on the journey to improved quality of life!​

Fill Out Intake Form​