Contact - Catamount Telepsychiatry

Welcome to Catamount Telepsychiatry

If you would like more information about the practice and are interested in becoming a patient, please fill out the below Contact Form and someone from the office will respond by email or phone.

For new patients, use the Patient Intake Form

Thank you.

Contact Dr. Upton

Patient Intake

Legal First Name:*

Legal Last Name:*

Preferred Name and Pronouns

Street Address

Street Address Line 2

City

State

Zip Code

Country

Home Phone

Work Phone

Cell Phone*

Ok for Message? Ok for Message? yes no

Email Address*

Birth_Date

Current age*

Gender on record if using health insurance

Referred By:

PCP

Reason for Appointment*