This short questionnaire helps us determine whether you may qualify for TMS based on common clinical and insurance criteria. It takes about 2 minutes to complete.
Our intake team will review your responses to help guide the next steps. This is a preliminary screening, not a medical evaluation.
What happens after you submit
- If you meet the preliminary criteria, a member of our intake team will contact you within two business days to schedule a consultation.
- If you don’t yet meet the criteria, we’ll share next-step options and resources.
Your information is handled securely. Please do not upload medical records or sensitive documents through this form.
If you have questions, please contact us at 773-970-6700.
If you are in crisis or need immediate help, call 988 or seek emergency care.
