Therapy Prescreen Form

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Therapy Prescreen Form

Thank you for choosing TK Center for Healing & Wellness. Please answer each question honestly and to the best of your knowledge. Please type “N/A” if the question does not apply to you.

*Please be advised there is a current waitlist for new clients and you will be reached out to only upon an opening that fits the availability you list on this form*

*Submitting this form is NOT an agreement or start of services*

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