Logo is present

Rise Request For Help

READ before making your choice: by clicking yes, you will be directed to our confidential appointment request form; once you submit the form, you will receive a confirmation email in your inbox. 

If you are able to receive emails without any concerns, please select YES to complete our confidential appointment form.

If you are not able to receive an email due to safety concerns, please select NO below. This will take you a separate form to get information on how we can best reach you.