New Patient In-Take Form

Thank you for choosing Partners in Therapy & Wellness. To ensure we provide you with the best possible care, please complete the following intake form wth accurate and up-to-date information. This form helps our care team understand your medical history, current health status, and any special needs you may have.

Your Privacy & Security Matter to Us

We take the security of your personal and medical information seriously. Our online form is procted with industry-standard encryption and security measures to keep your data safe. Your information will only be used for medical and administrative purposes in accordance with HIPAA and other applicable privacy laws.