We Specialize in Counseling Services for Adults, Adolescents, Children, Couples and Families
Forms
Please fill out the appropriate forms below. You must be able to open & print PDFs, and bring them in before your scheduled appointment. You may also mail completed forms to our address or email them to
mhwc2020@mentalhealthwellnesscenter.com
and we will schedule you.
Patient Registration Form (for new patients and patients with name, address or insurance changes)
Financial Policies (for all patients)
Authorization for Verbal Communication and/or Voicemails (for all patients)
Authorization to Release Medical Records/Information
HIPAA Acknowledgment and Consent Form (for all patients)
New Patient Packet (includes all of the five forms above)
