Patient Forms

At Health Within Wellness Center, we strive to give our clients the best experience possible. From here, you can view, download, or print any form required for a visit.

By printing and filling out common forms at home, you can streamline your check-in process! If you prefer to come into the office to fill out a form, we also have them on hand.


If you have any questions, don't hesitate to contact us.


Waiver Form

If this is your first time with us, please print and fill out the form below! This form is used for all new patients and overviews our waiver policy.

Download or Print

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Intake Form

This form is used for all new patients and overviews the purpose of your visit and provides our staff with key information to best assist you!

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WLC Survey Form

This form is a brief survey abotu our WLC program.

Download or Print

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