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15 Minute Consultation

All Is Well provides a free 15 minute phone consultation with new clients before meeting for the first time. We have found this to be the best approach for us to build rappot and assess if you are the best match for our services. This will also allow time to gather contact information, ask questions, present concerns, and determine availability before the first session.


Those seeking services with us will need to complete our client paperwork located below. After completion of our consultation, we will proceed with gathering initial paperwork. Once information is completed and recieved, a notification will be sent with information regarding our electronic client portal. If a notification was not sent, please contact us so we can assist you. Completing the client paperwork before your appointment will expedite the business of check-in and allow more time to divulge into the therapeutic experience.

If you are unable to access the paperwork, you may complete the questionnaire at the first visit. We recommend that you complete the paperwork 20-25 minutes before your appointment time.

The client paperwork can be emailed to erock@alliswellhealth.org

Thank you in advance.


Client Demographics Form .pdf
Informed Consent Form .pdf
Client Intake Form .pdf
Financial Policy Agreement Form.pdf
Notice of Privacy Practices Form.pdf
Notice of Privacy Summary Form.pdf
Reduced Fee Agreement Form.pdf
Counseling Disclosure and Consent Form.pdf

Good Faith Estimate

You have the right to receive a ‘Good Faith Estimate” explaining how much your care will cost.

Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

  • You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.

  • Make sure your health care provider gives you a Good Faith Estimate in writing at least 24 hours before your clinical service or item. You can also ask your provider, and any other provider you choose, for a Good Faith Estimate before you schedule the service.

Client Portal

For current clients, click on the link to access the client portal. This will allow you to schedule appoinments, (e.g, Google Calendar), cancel appointments, maintain records, billing, and clinician availability.