NEITHER THIS FORM OR THE CLIENT PORTAL ARE NOT TO BE USED FOR EMERGENCY SITUATIONS. IF YOU OR OTHERS ARE IN IMMEDIATE DANGER OR EXPERIENCING A MEDICAL EMERGENCY, CALL 911 IMMEDIATELY.
One Middle Street – Portsmouth, New Hampshire 
+1 603.461.8382 | 1662 Post Road – Wells, Maine +1 207.613.6729
Mending Minds Counseling 