BetterHelp Request Form

We are excited to bring you services via BetterHelp.

Please email info@byeinstitute.org if you have any questions or require assistance with this form.

IMPORTANT: If you are experiencing a crisis

Call 911 if you or someone you know is in immediate danger or go to the nearest emergency room.

988 Suicide & Crisis Lifeline Call or text 988; Llame al 988 (para ayuda en español)

Use Lifeline Chat on the web (English only)

The Lifeline provides 24-hour, confidential support to anyone in suicidal crisis or emotional distress. Call or text 988 to connect with a trained crisis counselor.

Please tell us more what you are looking for:

Parent requesting services for myself
Parent requesting services for child
Youth requesting services for self

Tell Us More About Your Child

Name

First

Last

Email

Phone Number

Tell Us More About You

Name

First

Last

Email

Phone Number

How did you learn about us?

Please tell us how you learned about us.