Thank you for your interest in becoming a new patient! We are accepting new patients on a limited basis. Please visit our Office Information Page for details on fees and accepted insurance plans. To request a new patient appointment, use our Request form.
New Patient Registration Forms
Once your first appointment is scheduled, you will need to complete our New Patient paperwork below:
- Part 1: Financial Forms (4 Pages – Consents, Initials & Signatures)
- Part 2: Clinical Forms (8 pages – Clinical History, Question & Answers)
You may upload a copy of your Driver’s License and Insurance card(s) on the Request form.
All paperwork must be received < 7 DAYS prior to your appointment.
If you prefer to fill out the paperwork by hand instead, please print and complete our New Patient Registration Forms.
You may then scan and email them to frontdesk@wellbeingsys.com OR mail them to our office.
Text Appointment Requests and Non-Emergency Messages to 480.462.7807