Plan Your Visit
Consent Form and Intake Form Checklist
Please have the following ready:
- A digital scan or photo of the front of your drivers license.
- A digital scan or photo of the back of your drivers license.
- A digital scan or photo of the front of your insurance card.
- A digital scan or photo of the back of your insurance card.
- I have 10 minutes to complete the consent form.
Program Goals
Shantaé Elliott
Program Director: 301-747-7038
Email: [email protected]
Fobella Nzobella
Medical Director: (301) 747-7038
Email: [email protected]
Shirley Alexander
Clinical Director: (301) 747-7038
Email: [email protected]