Getting Started (IOP Form)

Fill out this form to get started with becoming a part of the Intensive Outpatient Program.

The name you want us to call you in sessions and in phone calls.

If you are not insured we will work with you to determine payment.

If you feel you are in crisis, please call the National Suicide Prevention Lifeline. It is a free, 24-hour hotline, at 1.800.273.TALK (8255) or the city’s suicide hotline 215-686-4420. If you are in an emergency, call 911 or go to your nearest emergency room. Mazzoni Center does not offer crisis counseling or emergency services