Request an Appointment Online

To request an appointment online, please fill out the following three-page form and click on "Submit Form". That's all there is to it.

The information will be received by the Kennedy Krieger Institute Care Management team who will be happy to answer any questions you may have and schedule an appointment for you with the appropriate services to meet your needs.

* Denotes that the field is required

Please complete this section for individual to be seen:


Although we have done all we can to protect the information transmitted through this form, we cannot guarantee its confidentiality or security. Your use of this form constitutes your agreement to the terms of our privacy policy. If you are concerned about sharing protected health information, please call us, and do not enter the information here. Your email address will never be shared with third parties, and you can unsubscribe at any time.