• Welcome to C4 Wellness Clinic

    We’re excited to help you take the next step toward better health. Please complete this brief form, and Ashley Austin, APRN, FNP-BC, will personally review your request and contact you within one business day.Please do not include personal medical information on this form.Once we connect, you’ll receive a secure patient intake packet through our patient portal.
  • Format: (000) 000-0000.
  • How can we help you today?*
  • Have you been treated by C4 Wellness Clinic before?*
  • Preferred Method of Contact*
  • Best Time to Reach You*

  • 🎉 Thank You!


    We’ve received your request.

    Ashley Austin, APRN, FNP-BC, will personally review your submission and contact you within one business day.

    What happens next?
    ✔ We’ll reach out using your preferred contact method.

    ✔ We’ll answer your questions and discuss your goals.

    ✔ You’ll receive a secure patient intake packet through our patient portal.

    We look forward to partnering with you on your health journey.

    C4 Wellness Clinic

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