Patients and Providers
Intake & Referrals
Take the Next Step Today
Welcome to The Psychological Wellness Clinic's Intake and Referral Page.
Whether you're seeking to begin your journey toward mental wellness or a fellow provider looking to refer a patient, please complete the form below. Once completed, you, or the referred patient, will be contacted by our admin team within 24 hours to continue the intake process and book your first appointment. We look forward to working with you to support your mental health and well-being!
New Patient Intake and Referral Form
"Amazingly empathetic and respectful. Great listener and value driven therapy. Respects my boundaries and helped me uncover parts of me that I’ve blocked. Thank you for the growth and for being such a safe space for me to bloom."
