Initial Intake Forms

fillingoutformsborderbeigeWhen initiating services with Centered Wellness, we do our best to provide you ease and efficiency to more quickly begin addressing your needs. However, this process is also important to our understanding of your unique experiences and to help us get to know one another.

In order to help our processes run smoothly and to get you started quickly, we kindly request you complete the New Client Intake Packet located below prior to your first scheduled appointment and bring all included forms with you. We will not be able to provide services at your initial appointment without its full completion.


Download the full packet here: New Client Intake Packet

OR

Forms are available for individual download below:

Policies and Procedures

HIPAA–Notice Privacy Practices

Informed Consent For Services

Client Information Form

Credit Card Authorization/Financial Agreement Form

Optional: Consent to Obtain/Release Protected Health Information (PHI) Form


BOOK AN APPOINTMENT ONLINE!

OR

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