Arcara - Home Page
264 Beacon Street Boston, MA 02116 / 8 Lyman St. Westborough, MA 01581

First Visit Intake Form

Give Cindy, our Practice Manager, a call at 857-301-9842. You may leave a voicemail and she will call you back as soon as possible. You may also fill out our online intake form below which will be sent directly to Cindy.

**We do not treat anyone under the age of 14.**

Email/Internet Privacy Notice: I understand that any information sent from this website is not encrypted and therefore my privacy cannot be guaranteed while it travels on the internet. While unlikely, I accept that a breach of my privacy could occur when sending this information over the internet and/or when communicating by email and I am willing to accept that risk. I also understand that I have the option of calling the office so that I may leave this information on Cindy's voicemail.

yes no  * Required

***Please note that the caller ID may not say our company name***


Private Pay (Check, Mastercard, Visa)
BU Student Health Plan
Blue Cross/Blue Shield
Blue Cross/Blue Shield - Out of State

Medication Management
Psychiatric Evaluation
Stress Management
Conduct Disorder
Schizophrenia / Schizoaffective Disorder
Substance Abuse
Addiction Disorder (Alcohol, Opiod, Internet, Sexual, Gambling, ect)
Anger/ Irritability
Eating Disorder
Sleep Disorder
Bipolar Disorder

Other chronic pain
High Blood Pressure
Cardiac Problems
Neurological Condition
Back or neck pain
High Cholesterol
Gastrointestinal Problems
Sleep Apnea or Other Sleep Problems
Asthma/Respiratory Problems
I do not have any medical conditions

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First Visit

You must set up a phone call with Cindy. She will call you during the hours you select on the form.


Our hours are 8:30am - 4:30pm. Screenings and appointments must be made during these hours.