Let’s connect

Hello, welcome to MCC. We are here for you.

Please fill out this confidential form and an administrator will contact you.

You may also call us at 781-631-8273 (Mon-Fri 8:30 am – 5:00 pm).

If this is an emergency,  call 911, your primary care doctor, or go to your local emergency room.

781-631-8273
Office Hours: 8:30 am - 5:00 pm
Clinical Hours: 8:30 am - 5:00 pm
66 Clifton Avenue
Marblehead, MA, 01945
United States
Directions

Mental Health Intake Form

"*" indicates required fields

Client Name:*
Caller (if other than client):
Relationship to Prospective Client*
Address:*
Client Birthdate*
MM slash DD slash YYYY
Preferred Communication:*
Preferred Communication*
May Leave Voicemail*
Does the person in need of counseling have flexibility to be seen during daytime/weekday hours?*
Preferred Appointment Day*
Select at least one day, and as many as are convenient.
Preferred Appointment Time*
You must select at least one time period
Include any other notes about your schedule availability
Please share your challenge to help us expedite your placement.
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Mental Health Appointments

Our experienced team of clinicians supports all types of mental health needs, with the highest level of confidentiality and professionalism.

Request an Appointment

Social Services Appointments

The social services team is happy to help by providing 1:1 support for any immediate or future needs, questions and/or concerns.

Request an Appointment