Intake Forms
Child Intake
Package
We understand that making the decision to seek rehab
or wellness services for your child can be a big step.
This intake form will help us gather important
information to tailor a personalized plan for your child’s
success.
Teenage Intake
Package
Transitioning to adulthood can bring unique
challenges. This intake form allows you, as a teenager,
to share your experiences and goals with our team.
We’re here to support you on your journey to health and
well-being.
Adult Intake
Package
Taking charge of your health is empowering. This
intake form provides an opportunity to share your
medical history, lifestyle habits, and reasons for
seeking rehab or wellness services. Together, we can
create a plan to achieve your optimal well-being.
Ready to Get Started
Kindly fill out this form, and we'll reach out to you shortly.
- 1805 N York St., Suite H Muskogee, OK 74401
- (918) 912-2798
- (918) 513-5808
- 4619 S. Harvard Ave., Suite 102 Tulsa, Oklahoma 74135
- (539) 867-3151
- (918) 513-5808