Clinical Services

Clinical Intake Form

Please complete this form to request an appointment. A member of our clinical team will contact you as soon as possible.

Your privacy is important to us.

All information is confidential and secure.

What to Expect

Submit Intake Form

Complete this form with your information and preferences.

We’ll Be in Touch

Our team will reach out as soon as possible.

Schedule Appointment

We’ll work with you to schedule a time that works best for an intake call.

Start Your Care

You’ll meet with a clinician to begin your journey toward wellness.

Ongoing Support

We’re here to support you every step of the way.

Things to Know

  • This form is not an appointment. It is a request for services.
  • Completing this form does not guarantee immediate services.
  • There is no cost to submit this form
  • All information is kept confidential and secure.

Services We offer

  • Mental Health Counseling
  • Gender-Affirming Care
  • Sexual Health Services
  • Case Management & Resource Navigation
  • Groups & Support

Insurance & Payment

  • Contra Costa Health Plan
  • Medi-Cal
  • Sliding Scale Options
  • No one is turned away due to inability to pay

Need Support Immediately?

This is not a crisis center.

If you are experiencing a mental health crisis, please call or text:

1-8-777-565-8860

Trans Lifeline

844-844-5544

A3 – Contra Costa Crisis Response

Text 'HOPE' to 20121

Contra Costa Crisis Center

211

Contra Costa Crisis Information Line

988

Suicide & Crisis Lifeline

Text 'START' to 678-678

1-866-488-7386

The Trevor Project

1-800-846-1652

Behavioral Health Access Line

1-800-610-9400

Homeless Services for Youth

925-313-6771

HIV Case Management

925-313-6117

HIV Testing & PReP

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