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Please fill out the following form to request a callback, and we will contact you soon!
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Do you prefer to register online or by phone?
I understand that only the patient or their legal guardian should complete this form.
I am the:
The potential patient, or their parent/guardian, must fill out this “Schedule Now” questionnaire. Identification will be requested during the process. If they are not available, please direct the potential patient to this page at a later time. Healthcare providers can find referral information here.
We are taking patients ages 5-17. “You” in the following slides refers to the potential patient.
Are you seeking psychotherapy, medication management, primary care services or another evaluation type?
We are currently accepting new clients for psychiatric evaluations, psychotherapy, opioid use disorder treatment, and remote primary care services. If you have questions about our services, please click on Contact Us below, or call 503-694-3381
Our psychotherapy caseload is full. Patients in OR, WA and UT can join our waitlist by clicking the button below.
Learn more about psychiatric evaluations, which can help you determine a treatment plan. Call us at 503-694-3391 or email admin@skycloudhealth.com with any questions.
Limitations of Skycloud:
Have you attempted suicide in the past?
When was your most recent suicide attempt?
Unfortunately we do not have clinicians who are able to treat you via telehealth at this time. Please contact clinic at (503) 694-3381 with questions and check our list of resources.
Have you ever been hospitalized in a psychiatric unit or stayed in a residential mental health facility?
When was your most recent hospitalization or stay in a residential mental health facility?
Where do you reside?
We are only offering services in Oregon, Washington, Utah, New Mexico, Arizona, Minnesota, and Nevada at this time.
Are you currently prescribed a stimulant (e.g. Adderall, Ritalin) or benzodiazepine (e.g. Ativan, Xanax) and seeking to continue it?
Are you currently prescribed a stimulant (e.g. Adderall, Ritalin) or benzodiazepine (e.g. Ativan, Xanax) and seeking to continue it?
Are you currently prescribed a stimulant (e.g. Adderall, Ritalin) or benzodiazepine (e.g. Ativan, Xanax) and seeking to continue it?
Are you currently prescribed a stimulant (e.g. Adderall, Ritalin) or benzodiazepine (e.g. Ativan, Xanax) and seeking to continue it?
We prescribe controlled substance medications (i.e. stimulants, benzodiazepines) only to patients in OR, WA and UT with a required minimum once yearly in-office visit in Clackamas OR, Issaquah WA, or Layton UT when clinically appropriate (please view our stimulant policy). It may be helpful to note that in our practice, we rarely use benzodiazepines (e.g. Xanax, Ativan, Klonopin). Contact admin@skycloudhealth.com with questions.
In-office visits are required once a year in Clackamas OR, Issaquah WA, or Layton UT for patients who are prescribed controlled substances. Click “Okay” to continue.
We prescribe controlled substance medications (i.e. stimulants, benzodiazepines) only to patients in OR, WA and UT with a required minimum once yearly in-office visit in Clackamas OR, Issaquah WA, or Layton UT when clinically appropriate (please view our stimulant policy). It may be helpful to note that in our practice, we rarely use benzodiazepines (e.g. Xanax, Ativan, Klonopin). Contact admin@skycloudhealth.com with questions.
In-office visits are required once a year in Clackamas OR, Issaquah WA, or Layton UT for patients who are prescribed controlled substances. Click “Okay” to continue.
We do not prescribe stimulant, benzodiazepines, Suboxone, or other controlled substances in Minnesota. If you would still like to schedule, click Okay. To see other Resources, click “Resources.”
Which insurance plan do you have?
Which insurance plan do you have?
Which insurance plan do you have?
Which insurance plan do you have?
Which insurance plan do you have?
Which insurance plan do you have?
If your insurance was not listed, we may not be in your network. Please email billing@skycloudhealth.com to verify.
If your insurance was not listed, we may not be in your network. Please email billing@skycloudhealth.com to verify.
We do not see clients under 13.
Our provider is in process of panelling with your insurance. You can see him at a discounted self pay rate until he is contracted. Click below to schedule.
Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.
Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.
Thank you! Based on your response we need more information to ensure we can provide you with care, please click “next” to proceed.
Thank you! Based on your response we need more information to ensure we can provide you with care, please click “next” to proceed.
Are you currently prescribed a stimulant (e.g. Adderall, Ritalin) or benzodiazepine (e.g. Ativan, Xanax) and seeking to continue it?
We do not prescribe stimulant, benzodiazepines, Suboxone, or other controlled substances in Arizona. If you would still like to schedule, click Okay. To see other Resources, click “Resources.”
Which insurance plan do you have?
If your insurance was not listed, we may not be in your network. Please email billing@skycloudhealth.com to verify.
Please select an option below:
Please provide your contact information for a 15 minute free consultation phone call. Note: Do not use this form in an emergency.
Our psychotherapy caseload is currently open for Oregon patients. Patients in Washington and Utah can sign up for our waitlist, which is currently 1-12 months out, depending on age, state and insurance. Please provide the information requested below. Note: Do not use this form in an emergency.
Para agendar una cita, favor contactarnos al (503) 694-3381.
Proceed with online registration or by phone?
Phone Number: (503) 694-3381
Phone Hours: Mon – Wed 7:00 AM – 6:00 PM (PT) / Thurs – Fri 7:00 AM – 2 PM (PT)
Register below for a phone call, or call our office number (503) 694-3381 to register. Please only request a phone call for yourself.
Thanks for submitting this form! We will contact you during the specified times.
Thanks!
We do not see clients under 13.
Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.
We do not see clients under 13.
Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.
Are you currently prescribed a stimulant (e.g. Adderall, Ritalin) or benzodiazepine (e.g. Ativan, Xanax) and seeking to continue it?
We prescribe controlled substance medications (i.e. stimulants, benzodiazepines) only to patients in OR, WA , UT, and NM with a required minimum once yearly in-office visit in Clackamas OR, Issaquah WA, or Layton UT, when clinically appropriate (please view our stimulant policy). It may be helpful to note that in our practice, we rarely use benzodiazepines (e.g. Xanax, Ativan, Klonopin). Contact admin@skycloudhealth.com with questions.
Which insurance plan do you have?
If your insurance was not listed, we may not be in your network. Please email billing@skycloudhealth.com to verify.
We do not see clients under 13.
Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.
We do not see clients under 13.
We do not see clients under 13.
We do not see clients under 13.
Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.
Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.
*All times are in Pacific Standard Time (PST).
Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.
*All times are in Pacific Standard Time (PST).
Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.
We prescribe controlled substance medications (i.e. stimulants, benzodiazepines) only to patients in OR, WA , UT, and NM with a required minimum once yearly in-office visit in Clackamas OR, Issaquah WA, or Layton UT when clinically appropriate (please view our stimulant policy). It may be helpful to note that in our practice, we rarely use benzodiazepines (e.g. Xanax, Ativan, Klonopin). Contact admin@skycloudhealth.com with questions.
In-office visits are required once a year in Clackamas OR, Issaquah WA, or Layton UT for patients who are prescribed controlled substances. Click “Okay” to continue.
Which insurance plan do you have?
We do not see clients under 13.
Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.
Thank you! Based on your response we need more information to ensure we can provide you with care, please click “next” to proceed.
We do not see clients under 13.
We do not see clients under 13.
Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.
*All times are in Pacific Standard Time (PST).
Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.
Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.
We do not see clients under 13.
Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.
*All times are in Pacific Standard Time (PST).
Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.
Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.
Which insurance plan do you have?
Are you currently prescribed a stimulant (e.g. Adderall, Ritalin) or benzodiazepine (e.g. Ativan, Xanax) and seeking to continue it?
We do not prescribe stimulant, benzodiazepines, Suboxone, or other controlled substances in Nevada. If you would still like to schedule, click Okay. To see other Resources, click “Resources.”
If your insurance was not listed, we may not be in your network. Please email billing@skycloudhealth.com to verify.
We do not see clients under 13.
In-office visits are required once a year in Clackamas OR, Issaquah WA, or Layton UT for patients who are prescribed controlled substances. Click “Okay” to continue.
Which insurance plan do you have?
Thank you! Based on your response we need more information to ensure we can provide you with care, please click “next” to proceed.
Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.
We do not see clients under 13.
We do not see clients under 13.
Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.
Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.
We do not see clients under 13.
We do not see clients under 13.
We do not see clients under 13.
We do not see clients under 13.
We do not see clients under 13.
Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.
Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.
Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.
We do not see clients under 13.
Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.
If your insurance was not listed, we may not be in your network. Please email billing@skycloudhealth.com to verify.
Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.
Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.
Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.
Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.
Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.
Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.
Kindly send us an email to admin@skycloudhealth.com with your full legal name, date of birth, phone number, and attach clear images of both the front and back of your insurance card. This will allow us to verify whether your insurance plan is in-network.
Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.
Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.
Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.
Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.
Registration forms must be completed within 24 hours of booking or appointment will be cancelled. Forms take 15-20 minutes to complete. Please have your payment method, state ID and insurance card available.
If your insurance was not listed, we may not be in your network. Please email billing@skycloudhealth.com to verify.
Your information is kept confidential and helps us ensure we can provide you with care. Assistance: 503-694-3381 | admin@skycloudhealth.com
If you are in a mental health crisis, do not use this form, call 988.
