Details of Our Privacy Policy
Coaching Intake and Agreement Form – Encrypted Digital Format
Alternatively the following fillable PDF’s are available for mailing, if preferred by the coaching client:
Coaching Registration Form & Coaching Client Agreement
Provider Teleconferencing Zoom Agreement
New Patient Intake and Agreement – Encrypted Digital Format
Alternatively, the following for fillable PDF’s are available for mailing, if preferred by the patient:
New Patient Registration Form & Patient Agreement Form
Email and SMS Text Use Policy/Agreement
Provider Teleconferencing Zoom Agreement
Worker’s Compensation Intake and Agreement – Encrypted Digital Format
Alternatively the following fillable PDF’s are available for mailing, if preferred.
Worker’s Compensation New Referral Intake and Agreement Form
Provider Teleconferencing Zoom Agreement
Child Counseling Forms: Dr. Cynthia Wimberly
Wimberly Clinic Registration & Agreement Forms for Guardian and Adolescent
Email and SMS Text Use Policy/Agreement
Provider Teleconferencing Zoom Agreement