Suite 303
Media, PA 19063
Welcome to Rivera, M.D. Psychiatry.
This is an Introductory form that helps determine if we're a good fit for your unique needs.
This does not address urgent or emergent situations.
If you are or believe you are experiencing a medical or psychiatric emergency, including suicidal or homicidal thinking, side effects to medication, or any other urgent or time-sensitive matter in which you need an immediate response, do not use this service. Instead call 911 or go to your closest emergency room/crisis center.
Otherwise, please complete all required fields.
If you are completing this form for someone else, please enter your child's name for the patients name, and include your full name, your contact information, indicate your relationship to them (mother, father, legal guardian, etc.).
After receiving this completed form, someone will reach out to you to arrange for a required complimentary 15-minute introductory call. You can also book it directly using this link (also found on my website):
https://RiveraMDpsychiatry.intakeq.com/booking
Hope to connect with you soon.
~ Dr, Rivera