New Client Intake Form

• Picture It, Then Proceed - Before you dive into the online form, we strongly suggest snapping a pic of your government-issued ID and both sides of your insurance card. You’ll need to upload these to complete the process. Don’t worry, we don’t need your credit card info until you book an appointment. 

• Pro tips - To make life easier, use a device with a large screen to fill out the form. You will be asked to provide the name and contact information of the guarantor for your care, the subscriber for your insurance, and your emergency contact. Also, you will be asked to upload images of your current government issued photo ID, as well as, the front and back if your insurance card to complete the form. Having this information available will assist you complete the form. This form will take approximately 30 minutes to complete. The form is only available online. There is no paper version of this form. The form cannot be started and saved to complete at a later time. Please ensure you have the time to complete the form once you begin. To avoid potential data loss do not start the form and then leave the tab open to complete at a later time. 

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• Paperless, Organized, Frictionless Intake - Our online intake process is designed to be quick, easy, and private. For security reasons, you can’t start and save the form to finish later—it’s a one-shot deal. And yes, it’s only online—no paper forms here! 

• Thoughtful & Thorough - We encourage you to fill out the form as honestly and thoroughly as you’re comfortable. Your privacy is our priority, and we’re here to help. We ask that you approach the online intake form thoughtfully so we can truly understand you in a meaningful way. Completing the form with care helps us help you better. If we don’t have the details we need, we might not be able to provide the support you seek. Skimming through and forcing the form might limit our ability to assist you.

• Collaborate & Coordinate - Wellness Solutions will do our best to match your preferences for care. If we can’t, we will provide the available options so you can make the best informed decision for yourself. WS can’t guarantee an appointment or a specific clinician—new client appointments depend on clinical availability, expertise, and the client's schedule.

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• Understanding, Patience, & Quality Care - We only collect the information to provide quality personalized care and required by Federal law, Texas law, and insurance regulations. We cannot provide care to a client without collecting client information, insurance information, and the permissions and consents required. We understand that some clients may not be comfortable providing certain information and we respect your rights and your comfort. Please complete the forms as much as you are comfortable and feel emotionally safe. We honor your right to exercise discernment with your personal information. We will make decisions regarding a client's admission to care based on the information provided. 

• Encouragement & Celebration Stickers - We included encouragement and celebration stickers throughout the intake form to help provide support and positive vibes as you complete the intake process. We aim to make your care journey with Wellness Solutions positive. We also include emails to support your new client onboarding to provide valuable information and empower your experience.  

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• Click the button below to complete the new client intake form.