Getting Started:

Intakes are being schedule as telemedicine appointments until further notice.

Complete the screening form below and mail, email, or fax it to the office as noted below.

*By completing this paperwork, it does not guarantee that you will become a patient of Laurie Muhlbauer, PMHNP-BC.  This is to help determine the fit between the individual and provider.   

Mail: Laurie Muhlbauer, PMHNP-BC at 910 Capitol St NE, Building C, Salem, OR, 97301

Fax: Laurie Muhlbauer, PMHNP-BC at 855-541-6860. 


                                                                                           Adult Screening Form



                                                                             Teen/Adolescent Screening Form

For intakes:

Please, arrive on time.  If you are more than 5 minutes late you may be considered a “no show.”

Minors need to come with parents.