Register for Services

Registration is simple.  If you are a prospective client begin your registration over the phone (parent or guardian may register a minor).  See our LOCATIONS page for hours of operation, phone and fax numbers.  Or, you may download a registration packet from the link below.  Or, call and request a registration packet to be mailed to your home address.

Submit registrations completed remotely to the desired clinic location via email scan, USPS mail or fax.  After the registration is processed, you will be given an appointment for a clinical intake.

Bring with you or send copies of the following items:

  • All current Insurance Cards – primary and secondary
  • Photo ID
  • Patient Social Security Card
  • Primary Medical Doctor’s name, address and phone number

If Patient is a minor, you will also need to bring in or send copies of:

  • Proof of custody ( Custody order)
  • Proof of address
  • Immunization record
  • Birth certificate

If you currently have no insurance, please bring in or send copies of the following for income verification:

  • 3 most current pay stubs  OR
  • Prior year tax return

Notes:

Children are not required to attend the registration meeting.

Acceptance and schedule for intake is dependent on qualifying for services, and if required, obtaining authorizations for services.

Failure to provide all necessary documents can result in no scheduled clinical visits.

Please be advised that there is a Wait List for ALL private insurance. In order to be added to the list, the registration process must be completed.


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Are you between the age of 16 - 26 and looking for a way to connect with others also living with anxiety, depression, loneliness or other mental health concern? Taking Flight is hosting a group chat this week. Email hrizkallah@mdcoalition.org for the link to their group. You'll definitely want to check it out.This week we are on Discord! Join us tomorrow at 5pm for a dedicated chat and throughout the week for additional support. DM or email hrizkallah@mdcoalition.org for the link to our group
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Crossroads is proud of our wonderful, caring staff and we wanted to share some of their proudest moments with you this week! Meet Daniel Edris, one of our Residential Associates who has been with us for almost two years. He works closely with our clients in the residential program to develop and strengthen their daily life skills. For clients who need more intensive support, Daniel is there to coach them and assist them when they need him.

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