Registration Forms

Record Requests

If you need all or part of your counseling record, please allow 5 business days.

Medical Details

If you are new to our medication management program please complete the form below, and bring it to your first appointment.

  • Medical History Form

Insurance Update Form

Complete the form below if you are an existing client, or if you are a new client who has been instructed to provide additional insurance information.

Need help with our online check-in process? Our new online check-in and registration process is simple and convenient.