Request an Appointment

Interested in learning more or ready to take the next step?

Give us a call at (617) 259-1895 or fill out our quick, easy online intake form below. We're here to help.

appointment

At CPA we try to make the process quick and easy for you. The fastest way to find out about availability at CPA is to complete our online intake form. Note that we care about your privacy and we do not ask you for your date of birth or social security number over the internet. You will need your insurance information (including your name as it appears on your insurance card and your ID number) to complete the form so that we can verify your payment options. It is important to complete all fields so that we may quickly and accurately determine which clinician can best meet your needs.

Once you have completed the intake form it will be reviewed by our Intake Department staff who will attempt to match you with an appropriate clinician. At CPA, we strive to provide excellent service and will endeavor to contact you as soon as possible, usually within two business days. Please note that submitting this form does not guarantee an appointment. If we cannot accomodate your needs, we will work to provide you with additional resources and referrals.

Online Form:

Email/Internet Privacy Notice:

I understand that any information sent from this website is not encrypted and therefore my privacy cannot be guaranteed while it travels on the internet. While unlikely, I accept that a breach of my privacy could occur when sending this information over the internet and/or when communicating by email and I am willing to accept that risk. I also understand that I have the option of printing this form and faxing it in or calling the office so that I may leave this information on the intake message line. Please note: online requests receive the fastest response

You may Print Intake Form PDF & fax to (617) 259-1899.

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