Appointment Request

Thank you for considering this practice as your partner in comprehensive health care and personal wellness.

If you're a new patient, you may complete the "Appointment Request" form on this page to receive a new patient packet. 

You may also phone the office voicemail at 925-784-4000, especially if there is a more urgent matter or if you do not receive a new patient packet by email within 24 hours (please leave your nameemail address, and phone number.)

A new patient packet will be emailed to you shortly after contacting the office.

Generally, the online contact form on this website is the most rapid way of contacting the office to set up a new patient appointment.

Once you receive the new patient packet, please complete the forms and either fax the completed packet (all pages) to the office or you may scan and email the .pdf to the office. 

The office fax number is

Once the packet is returned to the office, it will be reviewed and put into queue for scheduling. You will be contacted by email with the proposed new patient appointment date and time. You are also encouraged to contact the office via this website or by email to check on the status of your new appointment.

24 HOUR CRISIS LINE 1-800-309-2131

24 HOUR LINE 1-800-273-8255


Note: To download Adobe Acrobat Reader for free, click here.

*Website Content Copyright 2022 CNS Medical Group, APMC. All Rights Reserved*


We are committed to your privacy. Do not include confidential or private information regarding your health condition in this form or any other form found on this website. This form is for general questions or messages to the practitioner.

Please don't put anything here:
Please enter the words below: Click to reload image What is this?

By clicking send you agree that the phone number you provided may be used to contact you (including autodialed or pre-recorded calls). Consent is not a condition of purchase.

Daniel Kostalnick, MD specializes in therapy and counseling services for Depression, ADHD, Anxiety, Bipolar Disorder, Suicide, Panic Attacks, and Obsessive Compulsive Disorder (OCD) in and around Pleasanton, CA and its surrounding communities.
Proudly serving: Pleasanton, San Ramon, Livermore, Dublin, Danville, CA and their surrounding communities.