Send Us A Message To contact us, please call/fax: (239) 533-9860, email: info@gulfshorebh.com, or fill out the form below: Please enable JavaScript in your browser to complete this form.Name *FirstLastEmail *EmailConfirm EmailPhone Number *SMS/Text Opt-InI consent to receiving SMS/text messagesI am opting-in to receive communication from Gulfshore Behavioral health via SMS/text message related to the services I may receive which may include, but is not limited to, scheduling and billing information. The frequency of the text messages to be sent may vary. There are no fees associated with subscribing. Data and message rates may apply. Text STOP to end SMS/Text communication. Text HELP to obtain additional information.I am inquiring about services for: *A minor childMyself and I am an adult (18+)Another adultOtherI am interested in: *Therapy/CounselingTesting/AssessmentBoth Therapy & TestingMedicationUnsure/UndecidedProvider Preference *No Preference and/or First AvailableDr. Samantha DenBoerLeslie Danner, EdS, LSPDr. Hannah StromKristy Woods, EdS, LSPDr. Shannon SweitzerDr. Calia TorresDr. Marie Dona (Psychiatry)Dr. Amanda McDonald (Psychiatry)Insurance Company:(This information is used to prepare our response to you regarding in-network or out-of-network coverage and does not influence scheduling or provider availability.)Message *I have read and agree *By checking this box, I understand that although the information I provide in this contact form may be considered privileged and confidential, sending a message via this form does not establish a doctor-patient relationship. Given the limitations of the communication format, this is not considered a HIPAA-compliant messaging service. Please do not provide confidential information. If this is a medical emergency, please contact 911 immediately.Submit