Patient Forms | Willow Holistic Wellness

New Client Forms

Congratulations on taking the next steps to improved emotional health and wellness!

The below forms must be completed and delivered BEFORE your first mental healthcare appointment! Failure to complete forms may result in your appointment being canceled or rescheduled. There are no refunds on payments for appointments canceled or rescheduled due to lack of completed paperwork.

New Patients

Please begin with filling out the registration forms with step 1. Our staff will instruct you on when to proceed to step 2.

Complete New Patient Intake Forms

Lake County Ohio Mental Health

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emergency telepsychiatry

Ohio Child Psychiatry

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Current Patients

At times our staff may direct you to update your information. Please click the forms below to fill out and submit online (all three are required for the annual update).

Patient Information Update Form

Consent and CC Authorization Forms

Other Miscellaneous Forms

Release of Information

Medical History Update Form

FullScript

Online Herbal Supplement Pharmacy

Willow Holistic Wellness's Providers may recommend herbal supplements to a patient to help manage their mental health conditions.

Patients are free to purchase their supplements from any reputable health and wellness store either in person or online.

In the event, a recommended supplement that is not readily available at your local health and wellness store (or if the local store is closed due to social distancing) you can check the FullScript Catalog HERE.

*Willow Holistic Wellness and it's Providers DO NOT receive any compensation from FullScript, any of its partners, or affiliates.

The listing of FullScript on this website is for convenience purposes only and should not be considered an endorsement of any particular product or service.