Visit us Mon-Fri from 9:00am to 6:30pm
 3825 Market St, Suite 4
Patient Portal
New Patient Registration

Registration is required for all services provided at Wilmington Mental Health. We recommend that you call ahead of time to schedule an appointment. Please have a valid identification, insurance cards and any documents from your previous treatment(s) with you during your first visit. Also, please plan to arrive at least 30 minutes prior to your appointment to complete our intake packet.
We use registration forms to obtain core data and identify our patients. The information we ask helps us better understand your situation and design a treatment that fits your needs. To save time when you arrive for your first appointment, please complete our intake packet online. If you prefer, you can download the forms to your computer or phone where you can fill them out and print when is most convenient for you. If you decide to print them, please bring all pages to your first visit and arrive 15 minutes early. We will need a copy of your identification and insurance cards and a list of any medications you may be taking.
If you would like to be established as a patient, please call our office.
After you have completed the form and press submit, your data will automatically be sent to us for verification. We collect sensitive patient information online using HIPAA-compliant forms. The security and privacy of your personal data is our main concern and we take every precaution to protect it..
If you choose to send us a hard copy of the registration form by mail, please include a copy of your identification card and copies of the front and back of your insurance card and send the packet to our mailing address: 3825 Market St, Ste 4 Wilmington, NC 28403.
Joseph Rengifo
Sara Scott Ford
Sarah Mooring
Adam Howell
Please know that some documents contain time-sensitive forms that expire after a year or after a specified period. If any information about you changes during your treatment, please let us know.
You will be provided with a copy of our privacy practice notice and information on your rights and responsibilities.
Request An Estimate
Note: At WMH we ensure your information is up to date. We ask to verify your contact and insurance information at every appointment.