Intake Forms

To get started go ahead and select appropriate intake form below.

Forms can be faxed to (904) 374-3057 or brought in to our office
If you have any questions or concerns, please do not hesitate to contact us at (904) 562-1391

Meet The Clinicians

Dr. Marek Hirsch

Medical Director

Dr. Blazen Draguljic

MD

Raluca Harris

MSN, PMHNP-BC

Shazia Nackashi

APRN, PMHNP-BC
View our Clinicians >