Get Started | Braver

Now Serving Communities in MetroWest Boston, Rhode Island, and Eastern Connecticut

Get Started

Patient Portal

Our Program

Get Started

Tell us a bit about the patient, and when they're available for a visit.

Welcome to Braver!

If your family is already receiving treatment at Braver and want to enroll a new patient (such as another sibling or a parent), please add them to your family's account in the Patient Portal instead of filling out this form.

Patient Information

Patient First Name

Patient Last Name

Patient Date of Birth

MM/DD/YYYY

Patient Grade Level

Sex Assigned at Birth

Patient Gender Identity

Your Relationship to the Patient

Email

Phone Number

I agree to receive text messages regarding appointment reminders and treatment information from Braver at the number I provided. Message and Data Rates may apply. Message frequency may vary. You can STOP messaging by sending STOP and get more help by sending HELP. Email support@bebraver.com for assistance. No mobile information will be shared with third parties/affiliates for marketing/promotional purposes. For more information view our Terms of Service and Privacy Policy.

Address

City

State

Zip

Availability

Treatment at Braver usually involves a recurring weekly visit online, in the office, or at home or in the community.

Tell us what days and times would work for this recurring weekly visit. The more times you are available the more quickly we can match you with a treatment team.

Monday

Morning (9am-12pm)

1:30-2:30pm

3-4pm

4:30-5:30pm

6-7pm

7:30-8:30pm

Tuesday

Morning (9am-12pm)

1:30-2:30pm

3-4pm

4:30-5:30pm

6-7pm

7:30-8:30pm

Wednesday

Morning (9am-12pm)

1:30-2:30pm

3-4pm

4:30-5:30pm

6-7pm

7:30-8:30pm

Thursday

Morning (9am-12pm)

1:30-2:30pm

3-4pm

4:30-5:30pm

6-7pm

7:30-8:30pm

Friday

Morning (9am-12pm)

1:30-2:30pm

3-4pm

4:30-5:30pm

6-7pm

7:30-8:30pm

Saturday

9-10am

10:30-11:30am

12-1pm

Afternoon (1pm-4pm)

Preferred Braver Office Location

Insurance Information

Name of Insurance Company

Member ID / Policy #

Insured's Relationship to Patient

Insured First Name

Insured Last Name

Insured Date of Birth

MM/DD/YYYY

Do you have secondary insurance?

Account Information

What are you seeking help for?

Has the patient ever received mental health treatment in an inpatient, partial hospital, or intensive outpatient program?

How did you learn about Braver?

Ready to Participate?

Get in touch with us to discover if Braver's treatment program is right for you and your family.