Contact

Interested in setting up an initial evaluation?

Please complete the form on the right. Dr. Corgan will review your answers and contact you to set up an initial appointment.

Have Questions?

You can email psychiatry@sondracorganmd.com or call (267) 225-1745.

If this is an emergency, do not leave urgent information on voicemail or in this web form. Please call 911 for emergency services.

Your Name

First Name

Last Name

Name of Person You are Seeking Treatment For (if different from self)

First Name

Last Name

Date of Birth of Person who would be Receiving Treatment

YYYY

Your Phone Number

(###)

###

####

Your Email

Form of treatment you are seeking:

Psychotherapy

Medication Management

Both

Please briefly describe your reason for seeking treatment. (If you are currently on psychiatric medications please list these.)

How were you referred to Dr. Corgan?