Easy Registration and Intake

IF YOU ARE INTERESTED IN ACCESSING MEDIMENTAL CARE SERVICES, WE WOULD BE PLEASED TO RECEIVE YOUR NEW PATIENT INTAKE INFORMATION FORM. THIS FORM ASSISTS MEDIMENTAL CARE IN ASSESSING YOUR SITUATION, AND IN DETERMINING IF OUR SERVICES ARE RIGHT FOR YOU. THE PROCESS IS SIMPLE AND MAY BE COMPLETED ONLINE.

Once your intake form is submitted, we will respond to you rapidly with a preliminary finding of whether MediMental Care is a good clinical fit for you. If you are in need of financial assistance in obtaining care, we can discuss available options which may be feasible and affordable for you.

MediMental Care offers a variety of payment options and fee structures, adapted to the healthcare cost management needs of patients. Unlike most healthcare providers, MediMental care maintains a strong commitment to serving the needs of the traumatically injured who may lack the resources to pay for the treatment they need. We make it possible for patients to receive our top-caliber care in ways that are feasible and affordable.

Don't have an access code? Click below to register.

Have an Access Code? Click below to continue the intake process.