WEB New Patient - Getting Started v2

My name is Peter Forster. I am really glad that you are interested in my practice. If you fill out a couple of this form I can answer any questions that you might have. All of the information that you share is completely confidential.

The completed form will be emailed to a clinician at Gateway. As with all electronic communications, email is inherently insecure. If you want to guarantee the security of your message, please install a secure email service, like Virtru, and email our office manager directly at hershe@gatewaypsychiatric.com.

First Name *This question is required.

Last Name *This question is required.

Phone Number

Email Address *This question is required. This question requires a valid email address.

Are you ready to get started, or do you have questions about my practice? *This question is required.

WEB New Patient - Getting Started v2 - Los Altos

New Patient - Getting Started - Los Altos