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Personal information

Basic contact details for scheduling and care coordination. Clinical charting happens in the practice systems after handoff.

Step 1 of intake

First name *Last name *

Date of birth *

Phone *Email *

Street address *

City *State for visits *ZIP *

Preferred pharmacy (name + city if known)

Emergency contact nameEmergency contact phone

Anything we should know before the first visit? (non-urgent)Type your full name to confirm this information is accurate *

Submissions are emailed to the practice over encrypted mail for handoff. This site does not keep a clinical chart.

Dr. Matt Brown

Telehealth · IL, KS & MO

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OCD resources: IOCDF Find Help. Not for emergencies — call 911. © 2026 Dr. Matt Brown.