Better Mental Health & Wellness Pre-Screen Form
Welcome to Better Mental Health & Wellness! In order to provide the quickest response to your request for services, we ask that you complete the secure form below. (Only Dr. Moore, PMHNP-BC will have access to your information here.) 

If you are currently in need of crisis/emergency assistance, please do not complete this form and either contact 988 or present to your closest emergency room.

Please note that submission of this form does not create a provider-patient relationship. If we are able to accept you/your child as a patient at this time, we will reach out via SimplePractice, our records system, as soon as possible. If we are unable to accept you/your child as a patient at this time, we will reach out via e-mail to provide alternate referral sources. Thank you!
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