Contact Us

If you are having a Mental Health Emergency please call 988 or 911.

If you are a practitioner requesting an appointment for a patient, please click the Provider Referral Form button below.

It you are an individual requesting and appointment for your self or one of you children under 18, please click this link for our HIPPA compliant new patient appointment form.

Patient Self Referral Form
Provider Referral Form

Office Contact Information

Phone: (785) 992-1531 Fax: ??? ??? ???? E-mail: admin@selfconnectwellness.com

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We’re here to help! Call Us Today!

+1 785-992-1531