Washington Square Institute
Treatment Center

Schedule an Appointment

You may use this form to request an appointment for an intake interview or to ask a question about our services. Your contact information and any other information you provide on this form will be treated as private and confidential. We will respond to you shortly.

* Required

To Schedule an Appointment…

Please fill in all the required fields in this Intake Application and submit the form.
Fill in the form completely to avoid regular errors.


xxx-xxx-xxxx (use this format) - extension in second box if needed

Please be aware that no psychotherapy, psychoanalysis or counseling of any kind is provided via this website. If you are experiencing an emergency you should seek help at a hospital emergency room or call 911.

You may call WSI at 212 477-2600 or Email intake@wsi.org to
schedule an intake appointment if you are unable to use this form.

Chartered by the New York State Board of Regents     -     Contact Us for more information     -      © WSI, updated August 5, 2019