Appointment Request

Many questions about myself and my practice are answered throughout my website. If you have reviewed that information and are interested in finding out if we would be a good fit to work together, please fill out the form below. This form is my preferred way to have initial contact. Please keep in mind that this is a solo practice, so it may take me 2-3 business days to get back with you, but I will respond as soon as I can!

First Name

Last Name

Relationship to the person you are reaching out for (please put self is appropriate):

Phone number you wish to be contacted on:

Email you wish to be contacted on:

How were you referred to me:

Briefly summarize why you are reaching out:

Dr. Sheldon does in-person appointments at this time.

Dr. Sheldon does not participate in insurance plans. I understand people seeking services with her are responsible for payment in full at the time service is rendered.

If you are or believe you are experiencing a medical or psychiatric emergency, including suicidal or homicidal thinking, side effects to medication, or any other urgent or time-sensitive matter in which you need an immediate response, do not use this service. Instead call 911 or go to your closest emergency room. Please acknowledge that this request is not an emergency or urgent matter and that you wish to proceed.

I understand and agree that any information submitted will be forwarded to our office by email and not via a secure messaging system. This form should not be used to transmit private health information, and we disclaim all warranties with respect to the privacy and confidentiality of any information submitted through this form.

I understand and agree to the above statements

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Appointment Request

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