Please answer all of the questions below to schedule your appointment.

Once you submit the form, someone from our office will call you to confirm the day and time of your appointment. We thank you for your patience.

All information is kept secure and confidential

Thank you for choosing Rio Grande Counseling & Guidance Services

Your Name

Parent(s) or Guardian(s) Name (if applicable)

Your Residence Address

Your Mailing Address (for correspondence)

Primary Contact Telephone?

Other contact phones (cell, work)?

Email Address

What is the best time of the day to call you to confirm your appointment?

To finish scheduling your appointment, we will need the following:

Client Date-Of-Birth (Optional for now)

We will need your date of birth to confirm your identity and in case of emergencies.

Social Security Number (Optional for now)

We will need to collect your Social Security Number to verify your identity and in case of emergencies. You may also provide your Drivers License number instead.

Do you require special accommodations for a disability or any special cultural needs?

No special needs are required
Yes, I require special accomodations

Yes, Please Explain Below

(Optional) We serve a diverse community and want to do a better job at serving the community. Please list any other information that you would like us to know about you (such as race, ethnicity, nationality, biological sex, gender identity, sexual orientation, gender expression, preferred name(s), preferred pronouns, etc.)

Are you wanting "TeleHealth" or "In-Person" appointments?

It Doesn't Matter To Me (either TeleHealth or In-Person is fine)
I prefer "TeleHealth" (computer/phone) services only.
I prefer "In-Person services" at your facility only.

What are the three best days of the week that are good for you to have your first appointment us?

(click on the days below...it's ok to click more than one)

What are the three best times in the day or evening that are good for you to have your first appointment us?

(click on the times below...it's ok to click more than one)

Please tell us why you want to see us?

(It's ok to click on more than one)

Have you been recently discharged from any hospital?

Yes
No

Name of Hospital

Date of Discharge

Please Explain Briefly

Please tell us how you heard of us?

Please click on the "Schedule My Appointment" button below to submit your appointment information.

We will contact you by telephone to confirm your appointment day and time.

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Self-Pay Option

Self Payment Option for Therapy in Albuquerque New Mexico

All information is kept secure and confidential

To finish scheduling your appointment, we will need the following:

Mental Health in Albuquerque