Mandatory Disclosures
(Please, ALL clients download this file and keep for your records)
(Please, ALL clients download this file and keep for your records)
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Intake Paperwork
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ADULT INTAKE
(for couples, please complete one per adult) |
FAMILY/CHILD INTAKE
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All completed paperwork can be returned by
Email: [email protected] Fax: (970)550-7555 Mail: MindWise Institute PO Box 556 New Castle, CO 81647 Text (photo): (970)319-1999 (Only during the COVID-19 outbreak) |