If you are planning to participate in telehealth services at CT Psychiatric and Wellness Center, please sign this consent form and send it back by email, fax, or mail. 

Please note that telehealth coverage varies by insurance plan. If you are unsure whether your insurance plan covers telehealth services, please contact the Member Services number on the back of your insurance card. 

CPWC - Telehealth Consent Form

E-Mail: [email protected]

Fax: 203-643-2253

Hamden Office: 

2446 Whitney Avenue, 2nd Floor
Hamden, CT 06518

Woodbridge Office:

1 Bradley Road, Suite 404
Woodbridge, CT 06525