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Please complete this form. Asterisks (*) indicate a required field. If you a first time patient, please complete our Patient Forms here. Please be aware that e-mail is not a secure medium, therefore, communications via e-mail cannot be guaranteed as confidential. Thank you.
    I understand Susan Berlin & Associates does not accept any insurances and are not in network with any insurance companies. We are fee for service and accept payment in the form of cash or check only. In some instance’s we accept Venmo, Zelle or Credit Cards for payment.
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Contact Information

Address: 1054 31st. Street, NW, Suite 500
Washington, DC 20007

Phone: (202) 333-1787

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