New Client Intake & Assessment Logo

  • New Client Welcome to Wellness Form

    Please  complete this form and sign. You do not have to answer every question. Only answer what you feel comfortable with, sign, and submit. Answers to the questions listed here only serve aid in assessing treatment paths.  Thank you!
  •  - -

  •                                            Nutritional Analysis 

     ( For Those Seeking Help with Diet and Nutrition Only,if not interested, please Skip this Section and move on to sign and submit the form. )

     

  • On a scale of 1 (not willing) to 5 (very willing), please indicate your readiness/willingness to do the following: 

     

    To improve your health, how ready/willing are you to… 

     

  •  
  •  - -

  •                                  MindBeingWell: The Wellness Project                                                                                                    MindBeingWell@welltherapy.healthcare/(678)250-3093

                http:// www.welltherapy.healthcare

     

     

  • Should be Empty: