New Patient Form


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Andrew Aaron, LICSW
50 North Second St.
New Bedford, MA 02740
.........................................
Tel: 508-997-6091 x106
Fax: 508-999-7795

Capable of helping romantic partners with problems about which few therapists are experienced. Send Andrew an e-mail.

NEW PATIENT? Get started by submitting a New Patient Form.

Quotes For Strength and Love

Each gender views the other as childish in the areas of its own strength.

-Andrew Aaron

New Patient Form

Your Name

Your Email

Home Address

Date of Birth

Home Phone

Cell Phone

Relationship Status

Partner's full name

Partner's Date of Birth

Best days to call

Best time to call:

Anytime
Morning
Afternoon
Early Evening

Second best time:

Check with Your health insurance company for out-of-network mental health benefits to determine if they will financially help.

What kind of therapy interests you?

Sex Therapy
Marriage Counseling
Relationship Help
Individual Psychotherapy

What are some of the issues that you wish to address in therapy?

How Did you hear about Andrew Aaron?

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The Process of Becoming a New Patient

1. Submit the New Patient Form: After you submit the form on the right, Andrew Aaron will contact you by phone. He will try to call you as close as possible to the times you specified. If you wish to have your health insurance help with the expense, contact your insurance company to determine what you can expect from them. Important isurance questions are found here.

2. Have a Phone Conversation: During that phone call, he will ask more questions about your situation and the issues you would like to focus on in therapy.

3. Provide a Credit Card Number: Please have a credit card number ready to provide during the phone call. This is taken for security purposes. Two working-days advance notice is required to cancel or reschedule an appointment. Short notice cancelations and missed appointments result in an automatic charge to the credit card for the cost of the reserved hour.

4. Schedule an appointment: Together you will negotiate a mutually agreeable time for your first appointment.

5. Download Forms: Please download, fill out and bring to your first appointment these five pages.

The Art of Loving