Patient Forms

CLICK HERE to go to our online, secure intake form.

The intake form is offered through INTAKEq, a fully HIPAA-compliant service used by thousands of clinics & hospitals worldwide.

If you prefer to fill out the form by hand and bring it in, there is an option to do that once you click on the link above. You can also fill out the form electronically when you come in for your appointment.

Please arrive 10 minutes early to your appointment if you plan to do so.

© 2017 Wellspring Center for Health & Healing