New Client Forms

Your First Step Toward Renewal

Welcome to Mind Rejuvenation. We're honored to support your wellness journey. To help us understand your needs and provide the most personalized care, we ask that all new clients complete the intake forms before your first session. These forms are designed to be simple, confidential, and supportive of your goals. Whether you're seeking clarity, healing, or renewal, this first step ensures we begin with compassion, insight, and intention.

Once completed, simply bring these forms to your first appointment so we can start your journey with ease.

New Client
Initial Intake Form

Provides your basic information so we can get to know you and begin your care with understanding and clarity.

DOWNLOAD FORM

HIPPA
Authorization Form

Explains how your health information may be used and shared, and documents your privacy preferences.

DOWNLOAD FORM

Medication
Information List

Gathers details about your current medications–and those you've tried–to support safe, coordinated treatment.

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Financial
Policy

Outlines our financial guidelines so you know what to expect regarding payments and billing..

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Appointment
Policy

Covers our scheduling, cancellation, as well as our attendance expectations to help ensure smooth, consistent care.

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Emergency
& Crisis Policy

Clarifies what steps to take during urgent situations, what qualifies as a crisis, and how to quickly access support when you need it most.

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Treatment Consent
Med. Management

Provides key information about medication based treatment and confirms your consent for Medication Management services.

DOWNLOAD FORM

Telehealth
Consent

Explains how virtual appointments work and outlines your rights and responsibilities when receiving care remotely.

DOWNLOAD FORM

Contact Mind Rejuvenation

Start Your Healing Journey Today

Whether you’re ready to book your first visit or simply have questions about our treatments, we’re here to help. Fill out our contact form and a member of our team will reach out shortly. Every step you take toward wellness matters—and we’re honored to walk it with you.

Mind Rejuvenation

New Client Forms

New Client Forms

Your First Step Toward Renewal

Once completed, simply bring these forms to your first appointment so we can start your journey with ease.

Contact Mind Rejuvenation

Start Your Healing Journey Today

Whether you’re ready to book your first visit or simply have questions about our treatments, we’re here to help. Fill out our contact form and a member of our team will reach out shortly. Every step you take toward wellness matters—and we’re honored to walk it with you.

Hours

Mon - Thur

Fri

Sat - Sun

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