New Client Forms {Be The Change Health} | New Client Forms in Pewaukee

New Client Forms


Be the Change Health and Wellness is now offering Teletherapy due to the COVID-19 pandemic

Please call us for an appointment at 262-646-8288 and we will help you find the right therapist.

Download the Teletherapy consent form here:

1. Teletherapy Consent with ZOOM

2. Informed Consent

3. Patient information

4. Health information

5. Receipt of Privacy Practices

6. Privacy Practices

7. Patient Rights

8. Teen Health questionnaire

9. Child Intake form

10. Financial Form

11. Esogetic Colorpuncture Form

12. Release of Information Pewaukee Clinic

13. Release of Information Milwaukee Clinic

LOCATION

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Office Hours

Availability dependent on Clinician Schedule

Primary

Monday:

8:00 am-9:00 pm

Tuesday:

8:00 am-9:00 pm

Wednesday:

8:00 am-9:00 pm

Thursday:

8:00 am-9:00 pm

Friday:

8:00 am-5:00 pm

Saturday:

9:00 am-5:00 pm

Sunday:

Closed

Contact Us Today!

Interested in starting therapy? Yoga? Massage?