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Appointment Request

Ready to take the next step? Request an appointment with Archway Counseling and Psychiatry Services in Westminster, MD. Complete the form below and our team will contact you within one business day to confirm your appointment. New patients are often seen within 48 hours.

Schedule an Appointment

Request an appointment with Archway Counseling and Psychiatry Services.

Phone

This field is for validation purposes and should be left unchanged.

⚠ If you are in crisis, call 988, call 911, or go to the nearest ER. This form is not monitored in real time.

Contact Information

Your Name(Required)

First Last

Date of Birth(Required)

MM slash DD slash YYYY

This appointment is for(Required)

If for a minor, a parent or guardian must complete this form.

Phone Number(Required)

Email Address(Required)

Preferred Contact Method(Required)

New or Returning Patient?(Required)

Services & Preferences

Mode of Service(Required)

Type of Service(Required)

Provider Preference

We will do our best to accommodate your preference.

Primary Concerns (select all that apply)(Required)

Anxiety

Depression

ADHD

PTSD / Trauma

Bipolar / Mood Disorder

Panic Disorder

Schizophrenia

Eating Disorder

Relationship / Family Issues

Personality / Mood Disorder

Grief / Loss

Substance Use / Addiction

Other / Not Sure

Availability

Available Days(Required)

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Select all that apply.

Available Times(Required)

Early Morning (7am-9am)

Morning (9am-12pm)

Afternoon (12pm-5pm)

Evening (5pm-8pm)

Select all that apply.

How soon do you need to be seen?(Required)

Session Frequency

Insurance & Additional Details

Payment Method(Required)

Insurance

Self-Pay / Out of Pocket

Sliding Scale (please inquire)

Not Sure

Insurance Company Name

Member ID

Found on your insurance card.

Group Number

Primary Care Physician (PCP)

How did you hear about us?

Current Psychiatric Medications (including doses)

Leave blank if none.

Anything else you would like us to know?

Any additional context that might help us prepare for your first appointment.

HIPAA & Privacy Acknowledgment(Required)

I understand that my information will be kept confidential in accordance with HIPAA regulations. I consent to being contacted by Archway Counseling and Psychiatry Services to schedule my appointment.

Your information is protected under HIPAA. See our Privacy Policy for details.

Welcome to Archway Counseling and Psychiatry Services

We are dedicated to providing a safe and supportive space for you to explore your concerns and achieve your personal goals.

Contact Us

181 East Main Street, Suite 4,
Westminster, Maryland 21157
443.487.6681
Mon - Fri 8am-6pm
Saturday by appointment

Use of this site implies agreement to our Terms and Privacy Policy. Content is informational only and not a substitute for professional care. If you are in crisis, call 911 or 988 immediately.

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