Intake Survey

Thank you for taking the time to complete the Intake Survey. Your thoughts are very important to us and vital in maintaining the best client experience.

You will need your “Client ID Number” to start. Simply ask one of our staff members if you do not already have your “Client ID Number”.

Note: The system will only allow one Intake Survey per client.

Schedule an Appointment

Select the option that suits you best: in-person appointments provide face-to-face interaction and a comfortable space for sharing, while online appointments offer the convenience and flexibility of meeting from wherever you are.

Contact Us

Do not include confidential or private information regarding your health condition in this form or any other form found on this website. This form is for general questions or messages to the practitioner.

By submitting you agree that the phone number you provided may be used to contact you (including autodialed or pre-recorded calls). Consent is not a condition of purchase.