Mind Body Connection Health and Wellness
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Mind Body Connection Health and Wellness

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filler@godaddy.com

  • HOME
  • ABOUT US
  • SPECIALTIES
    • Depression
    • Bipolar Disorder
    • Anxiety
    • PMS/PMDD
    • Postpartum
    • ADHD
    • PTSD
    • Vitamin Lab
    • Suboxone
    • Weight Loss
    • Emotional Support Animal
    • Wellness Retreats
  • FOR PATIENTS
    • YOUR FIRST VISIT
    • PAYMENT & INSURANCE INFO
    • FAQS
  • RESOURCES
    • NAMI
    • NIMH
    • SAMHSA
    • APA
  • ONLINE COURSES
  • Blog
  • CLIENT WAITING ROOM
  • CONTACT US

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NEW PATIENT FORM

CLINICAL INFORMATION

Please tell us about the person for whom treatment is being requested

Please COMPLETE BEFORE Requesting YOUR FIRST APPOINTMENT.

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After completion of our pre-screen form, we will be able to review your request.

You will receive an email that will allow you to set up your patient portal  This cuts down on the headache of phone-tag, unanswered voicemails and other factors that may delay booking your appointment.

If we feel that you would not be a good fit for our practice based on your needs, we will inform you via telephone. This may be due to complexity, needs that we cannot meet (such as more intensive services or monitoring), or other factors. Thank you for choosing Mind Body Connection Health and Wellness.

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PROVIDING WEIGHT LOSS COACHING IN ALL STATES WITH SUPPLEMENT RECOMMENDATION. FOR SERVICES REQUIRING PRESCRIPTION MEDICATION/MANAGEMENT WE ARE CURRENTLY SERVING STATes ARIZONA, delaware, Hawaii, Nebraska,New Mexico, Nevada, and wyoming. ONLINE DIGITAL CLASSES AVAILABLE IN ALL STATEs.



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