Behavioral health clinic
Upperbrook Hollow Behavioral Health · Behavioral health clinic · Brattleboro, VT
Carys Wainwright is the intake coordinator at Upperbrook Hollow Behavioral Health, an outpatient behavioral health clinic, and relies on it to carry each person who asks for care from the first contact through screening and forms to a first appointment on the calendar.
HealthcareIntakeForms4 tables · 6 views · 3 forms · 2 dimension sets · 1 digest · 1 notification · 1 stage rule set · 1 agent
Use this templateRequest board
New client requestsNew request5
Ainsworth: adult therapyBH-4100Marguerite Ainsworth-Delacroix
Bellweather: teen therapyBH-4107Tobias Bellweather
Castellanos: couples counselingBH-4114Ximena Castellanos-Reyes
Dunmore: medication evaluationBH-4121Wilhelmina Dunmore
Eberhardt: substance use supportBH-4128Kwabena Eberhardt-Osei
Screening call done4
Fairweather: adult therapyBH-4135Lorcan Fairweather
Galloway: teen therapyBH-4142Saoirse Galloway-Ito
Pennywhistle: group programBH-4149Rosalind Pennywhistle
Ivanhoe: adult therapyBH-4156Thandiwe Ivanhoe-Mbeki
Paperwork sent5
Jessop: medication evaluationBH-4163Caspian Jessop
Kowalczyk: couples counselingBH-4170Perpetua Kowalczyk-Brandt
Tolliver: adult therapyBH-4177Casimir Tolliver-Varga
Marchetti: teen therapyBH-4184Nalini Marchetti-Oduya
Nightingale: substance use supportBH-4191Rufus Nightingale
Paperwork back3
Oyelowo: adult therapyBH-4198Briar Oyelowo-Strand
Pemberton: medication evaluationBH-4205Gwendolyn Pemberton
Quillfeather: group programBH-4212Aurelio Quillfeather
First visit booked6
Rasmussen: adult therapyBH-4219Folasade Rasmussen-Adeyemi
Sutherland: couples counselingBH-4226Percival Sutherland
Thackeray: teen therapyBH-4233Chidimma Thackeray-Nwosu
Underhill: adult therapyBH-4240Marigold Underhill
Vanderhoek: medication evaluationBH-4247Leopold Vanderhoek-Mensah
1 moreSeen6
Xanthopoulos: adult therapyBH-4261Isidore Xanthopoulos
Yarborough: adult therapyBH-4268Winifred Yarborough-Kasprzak
Zimmerman: teen therapyBH-4275Chukwuemeka Zimmerman-Okafor
Abernathy: couples counselingBH-4282Delphine Abernathy-Soto
Brockhurst: group programBH-4289Anselmo Brockhurst
1 moreWaitlisted1
Dellacroce: adult therapyBH-4303Hartley Dellacroce
Declined2
Eastwick: substance use supportBH-4310Anjali Eastwick-Banerjee
Fenchurch: adult therapyBH-4317Ludovic Fenchurch
Tables
New client requests
32 sample rows · 24 columnsEveryone who asked for care, from the first request through screening, forms and a booked first visit.
| Request | Request number | Client | Phone | Date of birth | Care wanted | |
|---|---|---|---|---|---|---|
| Eberhardt: substance use support | BH-4128 | Kwabena Eberhardt-Osei | (802) 555-0154 | kwabena.eberhardtosei@northmeadowpostbox.net | May 21, 1986 | Substance use support |
| Ainsworth: adult therapy | BH-4100 | Marguerite Ainsworth-Delacroix | (802) 555-0150 | marguerite.ainsworthdelacroix@northmeadowpostbox.net | Jan 1, 1958 | Adult therapy |
| Bellweather: teen therapy | BH-4107 | Tobias Bellweather | (802) 555-0151 | tobias.bellweather@elmgatemailhub.com | Feb 6, 1965 | Teen therapy |
| Castellanos: couples counseling | BH-4114 | Ximena Castellanos-Reyes | (802) 555-0152 | ximena.castellanosreyes@northmeadowpostbox.net | Mar 11, 1972 | Couples counseling |
| Dunmore: medication evaluation | BH-4121 | Wilhelmina Dunmore | (802) 555-0153 | wilhelmina.dunmore@elmgatemailhub.com | Apr 16, 1979 | Medication evaluation |
| Fairweather: adult therapy | BH-4135 | Lorcan Fairweather | (802) 555-0155 | lorcan.fairweather@elmgatemailhub.com | Jun 26, 1993 | Adult therapy |
| Fenchurch: adult therapy | BH-4317 | Ludovic Fenchurch | (802) 555-0181 | ludovic.fenchurch@elmgatemailhub.com | Aug 21, 1983 | Adult therapy |
| Galloway: teen therapy | BH-4142 | Saoirse Galloway-Ito | (802) 555-0156 | saoirse.gallowayito@northmeadowpostbox.net | Jul 4, 2000 | Teen therapy |
| Jessop: medication evaluation | BH-4163 | Caspian Jessop | (802) 555-0159 | caspian.jessop@elmgatemailhub.com | Oct 19, 1973 | Medication evaluation |
| Pennywhistle: group program | BH-4149 | Rosalind Pennywhistle | (802) 555-0157 | rosalind.pennywhistle@elmgatemailhub.com | Aug 9, 1959 | Group program |
| Eastwick: substance use support | BH-4310 | Anjali Eastwick-Banerjee | (802) 555-0180 | anjali.eastwickbanerjee@northmeadowpostbox.net | Jul 16, 1976 | Substance use support |
| Kowalczyk: couples counseling | BH-4170 | Perpetua Kowalczyk-Brandt | (802) 555-0160 | perpetua.kowalczykbrandt@northmeadowpostbox.net | Nov 24, 1980 | Couples counseling |
20 more rows
Calls and messages
46 sample rows · 6 columnsEach screening call, text or email with a person asking for care, and how it went.
| Note | Request | Channel | Outcome | Contacted on | Minutes |
|---|---|---|---|---|---|
| Screening call: Lorcan Fairweather | Fairweather: adult therapy | Call | Screened | Oct 2, 2026 | 21 |
| Screening call: Saoirse Galloway | Galloway: teen therapy | Call | Screened | Sep 30, 2026 | 24 |
| Sent the forms packet: Caspian Jessop | Jessop: medication evaluation | Forms sent | Sep 30, 2026 | 11 | |
| Screening call: Rosalind Pennywhistle | Pennywhistle: group program | Call | Screened | Sep 28, 2026 | 27 |
| Screening call: Caspian Jessop | Jessop: medication evaluation | Call | Screened | Sep 28, 2026 | 33 |
| Sent the forms packet: Perpetua Kowalczyk | Kowalczyk: couples counseling | Forms sent | Sep 28, 2026 | 8 | |
| Screening call: Anjali Eastwick | Eastwick: substance use support | Call | Screened | Sep 27, 2026 | 20 |
| Screening call: Thandiwe Ivanhoe | Ivanhoe: adult therapy | Call | Screened | Sep 26, 2026 | 30 |
| Screening call: Perpetua Kowalczyk | Kowalczyk: couples counseling | Call | Screened | Sep 26, 2026 | 22 |
| Sent the forms packet: Casimir Tolliver | Tolliver: adult therapy | Forms sent | Sep 26, 2026 | 12 | |
| Sent the forms packet: Briar Oyelowo | Oyelowo: adult therapy | Forms sent | Sep 26, 2026 | 10 | |
| Sent the forms packet: Isidore Xanthopoulos | Xanthopoulos: adult therapy | Forms sent | Sep 26, 2026 | 11 |
34 more rows
Referring offices
9 sample rows · 6 columnsThe doctors, schools and programs that send people, and how many requests each one brings.
| Office | Kind | Office phone | Sending clients since | Requests |
|---|---|---|---|---|
| A friend or family member | Word of mouth | — | Oct 5, 2021 | Rasmussen: adult therapy, Abernathy: couples counseling |
| Cobalt Ridge Employee Assistance | Employee assistance | (802) 555-0125 | Oct 5, 2023 | Fairweather: adult therapy, Quillfeather: group program, Brockhurst: group program |
| Found us online | Self-referral | — | Oct 5, 2021 | Castellanos: couples counseling, Pennywhistle: group program, Kowalczyk: couples counseling, Oyelowo: adult therapy, Sutherland: couples counseling, Xanthopoulos: adult therapy, Fenchurch: adult therapy |
| Hartwell Primary Care | Primary care | (802) 555-0121 | Oct 5, 2022 | Ainsworth: adult therapy, Dunmore: medication evaluation, Jessop: medication evaluation, Pemberton: medication evaluation, Vanderhoek: medication evaluation, Yarborough: adult therapy |
| Larch Valley Pastoral Care | Faith community | (802) 555-0126 | Oct 5, 2024 | Ivanhoe: adult therapy, Whitcombe: substance use support |
| Marlow Union School counselors | School counselor | (802) 555-0122 | Oct 5, 2023 | Bellweather: teen therapy, Thackeray: teen therapy, Zimmerman: teen therapy |
| Pinecrest Pediatrics | Pediatrician | (802) 555-0123 | Oct 5, 2022 | Galloway: teen therapy, Marchetti: teen therapy, Dellacroce: adult therapy |
| Riverbend Hospital crisis unit | Hospital | (802) 555-0124 | Oct 5, 2024 | Eberhardt: substance use support, Nightingale: substance use support, Underhill: adult therapy, Calloway: medication evaluation |
| Thornfield Urgent Care | Urgent care | (802) 555-0127 | Oct 5, 2025 | Tolliver: adult therapy, Eastwick: substance use support |
Also included
- Request boardStage rules
- Forms still outDigest
- New requestNotificationTells the intake coordinator the moment someone asks for care, so the screening call happens within a day.
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