Intake Form

ONLINE INTAKE FORMS

Waiver

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WCL Survey

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Patient Forms

You can now access your health intake questionaire using your computer/cell phone or laptop.  It will automatically import into your paient record in our office.  This new feature will allow you to maximize your time with your provider.  Please open the link above to start your questionaire.  Please answer the questions as completely and accurately as possible so that we may best serve you.  Other links will allow you to fill out and sign your HIPAA achnowledgement and all of our office policies.  When you call into the office before you arrive we will also be able to give you an estimate of what your care for the first visit will cost.  Thank you again for putting your trust in us for your heatlh & wellness needs.

Health Within Wellness Center

We’re accepting new patients.

Come in today and see what we can do for you!

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