Request appointment | Cognis Psychiatric Services

Cognis Psychiatric Services

Request an appointment

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Reason for care

Select date & time

1 Appointment info

2 Prescreener

Reason for care

3 Contact information

What is the reason for seeking care?

Anxiety Attentional difficulties Behavioral issues Depression Grief Relationship issues Substance use Trauma Other

What kind of care is being sought?

Psychotherapy Medication Other Not sure

What mental health concerns or treatment have occurred in the past?

In therapy now In therapy in the past Taking psychiatric medication now Taken psychiatric medication in the past Hospitalized for mental health reasons now or recently Hospitalized for mental health reasons in the past Known neurologic or genetic disorder Attempted suicide in the past None of these apply

Are you currently experiencing thoughts of harming yourself or others, or are you experiencing a mental health emergency?

If you answer "Yes," please call 911 or go to your nearest emergency department. Online appointment requests are not appropriate for urgent or emergency mental health situations.

No Yes

What are you hoping to achieve through treatment?

Please briefly describe your goals for treatment. For example, reducing anxiety, improving mood, managing ADHD symptoms, improving sleep, medication evaluation, therapy, or another concern.

Limited to 600 characters

For medical emergencies, contact your healthcare provider or call 911. For mental health crises, call or text 988.

Mariam Bello

Chicago

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THE CLIENT PORTAL IS NOT TO BE USED FOR EMERGENCY SITUATIONS. IF YOU OR OTHERS ARE IN IMMEDIATE DANGER OR EXPERIENCING A MEDICAL EMERGENCY, CALL 911 IMMEDIATELY.