Do You Have Maryland Medical Assistance?
Do You Have Other Insurance? (Commercial Insurance or Medicare)
Are You Currently Receiving Services From a Psychiatrist or Therapist?
If Yes, Can We Contact This Provider for Referral Information?
Have You Been Previously Diagnosed with a Psychiatric Disorder?
Do You Have a Disability?

I agree and understand that I will be receiving a call and emails from a staff member of Paragon Health Services. The purpose of the call is to understand more about my mental health care needs. There is no obligation to purchase any services. You agree to receive automated messages. This agreement is not a condition of purchase. Receive up to 2 messages per month. Reply STOP to opt-out or HELP for help. Message & data rates apply. Terms & Conditions can be found HERE.