Request a Behavioral Health Telehealth Appointment: Norwalk Public Schools

Norwalk Community Health Center and our BEHAVIORAL HEALTH Team extend a warm welcome to Norwalk Public Schools Students, Faculty, Staff, and Families!

Everyone Needs Help at Some Point in Their Life

Behavioral Health is the relationship between our behavior and our overall well-being. Untreated, symptoms can impact every area of life, making day to day functioning difficult and holding back you or someone you care about from living a full and healthy life.

Our Licensed Clinicians and Master’s Level Clinicians are available to you for

Individual psychotherapy
Couples and Family Counseling
Referrals for psychiatric medication management
Referrals to community resources

Please complete the form below and a NCHC staff member will contact you to verify the information submitted.

Download and complete the following forms before your visit:

Rights and Responsibilities/Consent for Behavioral Health Treatment: English | español
Norwalk Community Health Center Behavioral Health Referral Form: English | español
Behavioral Health Consent for Release and/or Exchange of Information: English | español

Click here to see the full range of our Behavioral Health team’s evidence-based treatments, behavioral and wellness services and areas of expertise.

This is not an appointment or cancelation confirmation.

Hours of operation for NCHC are Mon-Fri 8:00-5:00 and Saturday 8:00-12:00.

Calls will be returned during our normal business hours.

If this is an emergency, please call 911.

Is this Request for You?:(Required)

This Request is for:(Required)

Parent Name (if appointment is for student):

First Last

(if appointment is for student)

Name of Person for Requested Appointment:(Required)

First Last

(Student, Parent, Faculty Member or Other)

Date of Birth for Person Requesting Appointment:(Required)

Address:(Required)

Street Address Address Line 2 City State ZIP Code

Phone# for NCHC to Contact:(Required)

Email:(Required)

Enter Email Confirm Email

Please select an appointment time:(Required)

Please be aware, your requested appointment time could be subject to change due to availability. A NCHC staff member will contact you to verify the information submitted.

Insurance Information:(Required)

Name of Medical Insurance:

Policy #:

Message to NCHC:

Anything you would like our representatives to know before contacting you?