Schedule an Appointment - Behavioral Health

***If this is an emergency or you are experiencing chest pain, shortness of breath, or an allergic reaction, please call 911 or report to your closest Emergency Room immediately. Do not use this form for urgent medical needs.

Inspira Health Behavior Health Services, offers easy ways to schedule your appointment. You can make an appointment by calling 1-800-INSPIRA (1-800-467-7472) or you can request an appointment online by completing the information below. Please include the best telephone number including area code for us to reach you so we may finalize your appointment.

First Name

Last Name

May we send you health information by email?

Yes

Telephone

Date of Birth

Interpreter Needed

Additional Information

I would like to receive marketing messages from Inspira Health

Math question 1 + 12 =

Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.