New Client Appointment Request Form

Thank you for your interest in working with Rust Wellness Group!

Please complete this form to get started.

What to expect during the Intake Process:

• Complete this form to provide necessary information to get started

• Once you submit - you will be re-routed to our Appointment Request Portal. Here you can request a free 15 minute consultation with your preferred therapist (optional).

• Whether you request a consult slot or not, our office will reach out within 24 business hours to verify billing details (copays, fees, etc.) and confirm your consult request or assist you in connecting with one of our Therapists.

• After you have your consultation- you and the Therapist will decide if you would like to move forward to schedule an intake.

• You will have access to our secure client portal and complete necessary forms prior to your first session.

Email our office at services@rustwellnessgroup.com if you have any further questions! We look forward to hearing from you.