Initial Paperwork

Counseling or Testing-

Initial paperwork is on the client portal. You will need to complete an intake form and sign various consents.  After your appointment is made, you will receive a link to your portal through email.

If you do not have access to email, please let us know and you can complete the paperwork prior to your session in office.  Please allow yourself to come in 30 minutes early if you need to do this.

You are also required to put a credit card on file.  This will only be used in case of a no show or Late Cancel or for those doing telehealth.

Stem-Cell Therapy –

An initial consultation is required.  Please complete the below form.  Once received, a physician at Whole Life Wellness will review the paperwork.

Form Download Link

or go to and let them know you want to be treated here at Coastal Synergy.

You may email it to us at: or email to the address on the form.

Request An Appointment

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