We want to make your visit to as pleasant as possible. We ask that you arrive 30 minutes prior to your scheduled appointment time. To speed up the process you can download and fill out our new patient forms listed below.
New Patients: Please Print & Complete Before Your Session
24 hours prior to your appointment, we will need to collect some basic information to coordinate pre-verification. Please send us a copy of your valid ID, your completed new patient intake form and front and back of your insurance card (if applicable). Email all items to [email protected]
Remember bring your photo ID and insurance card--if using insurance--to your appointment.
For Established Patients Only
For every 12 visits in which you are a patient at ACT Wellness Center, we want to monitor how well your overall health has improved. Complete the Re-Evaluation Questionnaire form so we will be able to track your health improvement progress over time.
HIPAA (Print only if needed)
Please be sure to read our Patient Privacy Policies.
If you do not already have Adobe Reader® installed on your computer, click here to download.
Should you have questions about the forms, please contact our knowledgeable staff for assistance at (703) 491-9355. To get an overview of what happens next check out What Can I Expect?.