Request a Psychiatric Consultation

This brief form is for administrative routing only. It does not constitute a psychiatric assessment, establish ongoing care, or mean that a consultation has been accepted or scheduled.

Not for emergencies or crisis care

Do not use this form for an emergency, imminent safety concern, or urgent psychiatric assessment. In Israel, call emergency medical services at 101 or seek immediate emergency care.

Please do not send clinical details here

Do not include medical records, diagnoses, medication lists, trauma details, symptoms, safety concerns, or other sensitive psychiatric information. If the request appears appropriate, secure instructions will be provided for any clinical information that is needed.

Contact information

* Required

Full name *Email address *Phone number (optional)Preferred language *

Administrative routing

What type of consultation are you requesting? *Do you currently have an identifiable treating or prescribing clinician? *

Medication-focused consultations ordinarily require an identifiable treating or prescribing clinician who can receive and independently evaluate recommendations.

Required acknowledgments

I confirm that I am 18 years of age or older.I understand that I must be physically located in Israel at the time of the consultation, and I expect to meet that requirement.I understand that this service is not for emergencies or crisis care.I understand that submitting this request does not mean the consultation has been accepted, scheduled, or clinically approved.I understand that detailed psychiatric or medical information must be provided only through the secure process if it is later requested.

Fee: ₪2,750. If your request is accepted, payment is due before the evaluation. Cancellations with less than 48 hours’ notice may be subject to a practice late-cancellation charge equal to 50% of the consultation fee, subject to any cancellation or fee-limit rights that apply under Israeli law. Partial or incomplete evaluations are handled individually. One limited report-clarification interaction is included if requested within 14 calendar days after report delivery.

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