Integrated Wellness and Strategies, LLC
Integrated Wellness and Strategies, LLC

Client Forms

New clients will need to fill out several forms before therapy can begin. To make the process as smooth and efficient as possible, these documents may be downloaded from the below list. Naturally, all forms are also available at the office but filling them out in advance saves time if you are able to. You will need Adobe Reader to view these PDF files. If you do not have it, you can download it here for free. 

All the forms with an * listed below are required for all clients.  If you are unsure which forms you need to fill out, please don't hesitate to contact me.

*Client Information Form
Client Information - Insurance - IWS.pdf
Adobe Acrobat document [392.7 KB]
*Mandatory Disclosure & Consent for Treatment
Mandatory Disclosure Consent for Tx - I[...]
Adobe Acrobat document [400.5 KB]
*Media Policy
Media Policy - IWS.pdf
Adobe Acrobat document [349.4 KB]
*Cancellation & No Show Policy
Cancellation and No Show Policy - IWS.pd[...]
Adobe Acrobat document [339.1 KB]
*HIPAA Privacy Rights
HIPAA PRIVACY RIGHTS - IWS.pdf
Adobe Acrobat document [391.9 KB]
*Illness Policy
Illness Policy - IWS.pdf
Adobe Acrobat document [305.2 KB]
*Inclement Weather & Public Health Emergency Policy
Inclement Weather Public Health Emergen[...]
Adobe Acrobat document [353.1 KB]
*TeleTherapy Agreement & Consent
TeleTherapy Agreement Consent - IWS.pdf
Adobe Acrobat document [355.1 KB]
*Emergency Contact
Emergency Contact ROI - IWS.pdf
Adobe Acrobat document [324.4 KB]

This form is not required for all clients, but is included if needed.

Release of Information
Release of Information - IWS.pdf
Adobe Acrobat document [414.6 KB]

Location

Integrated Wellness & Strategies

 

Office Location:

11001 West 120th Avenue

Suite 400

Broomfield, CO 80021

 

Phone: 720-644-6378

E-mail: amber@strategiesintegrated.com

Fax: 720-446-3520

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