Adult Parent Child Intake Packet

You have just taken a very positive step coming to the Integrated Wellness Clinic. We are happy that you are with us. Please print the forms below and fill them out, then bring them with you to your first appointment.

The Intake forms may be downloaded from the list below. If you have not talked with a counselor or with the office staff, please call in after you have completed the intake forms to set an appointment with one of our counselors. We may be reached at 225-924-1910.

IWC – Client Contact Info
IWC Fax Cover Sheet
IWC Intake Assessment
Recurring Payment Authorization – IWC
Release of Information to Dr.
Therapist Change Request

doctor helping patient with adult intake packet