Client Intake System
New Clients Only
If you have used services at our clinic previously, we have your information on file already and you do not need to complete the form. Please call or email us to request an appointment.
For new clients, please click the following link to submit your information and request an appointment. Our staff will contact you within 72 hours to schedule an appointment. Please complete the entire form so we can ensure we meet your needs.
Frequently Asked Questions:
Q: Where does my information go?
A: Your information is transferred through a secure server and goes directly into our confidential Electronic Medical Records (EMR) system.
Q: Why don’t you have an online appointment scheduler?
A: As we provide a wide variety of services where appointments can range from 15 to 60 minutes, it is difficult to utilize an online scheduling system for appropriate booking.
Q: What happens to my information in the long-term or if I cancel an appointment?
A: Your information will always be protected in our secure EMR, which meets the requirements of the Health Insurance Portability and Accountability Act (HIPAA) that all healthcare providers follow.
