New Client Intake Forms


Thank you for scheduling an initial appointment with us. 

Please take a few minutes to complete our intake paperwork online.  This process uses bank-level security and is completely confidential. Completing the paperwork online will save you time when you arrive at your appointment.

There are two parts to the paperwork: Consents, and IntakePlease complete both parts prior to your appointment. If a question does not apply to you or you choose to not answer, please mark that question with “N/A”.

If you have any questions, please do not hesitate to email us at or call us at 717-219-5711.

Adult Intake (14 years old or older):

Child Intake (13 years old or younger):