Complete the form to become a new patient. Click "NEXT"> to advance each page.

It should take less than three (3) minutes. Click SUBMIT on the last page, and you will receive an email and text to schedule a call with a NEW PATIENT COORDINATOR to complete the process and answer any questions.

If you are unable to use this form, call 615-224-9800, Option 1, to talk to the New Patient Coordinator, or email newpatients@hopeforyourbrain.com for help.

We are pleased to accept all major insurance plans and Medicare, and we will verify your coverage during the process.