Skip to main content

New Client Intake Form

Please be sure to complete and sign this form prior to arriving for your initial appointment. This will greatly assist our team members in making your visit to our wellness center more seamless.

Have Questions or Need Assistance?

If you have any questions, or issues completing this digital form, please contact us at (503) 724-1212 for further assistance.

Learn How to Save and Complete Later

You can save this form at any time and continue at a later point. Just click the “Save and Continue Later” button at the bottom of this page. We will provide you with a dynamic link (URL) to this form with your saved information to continue completion when you are ready. To make this functionality possible, your information is saved on our server as you enter it.

We're Committed to Protecting Your Privacy

All of our online forms are hosted on a secure server. We will not, under any circumstances, share your personal information with other individuals or organizations without your express permission, including public organizations, corporations or individuals, except when applicable by law. We do not sell, communicate or divulge your information to any third-party mailing lists.