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    • About W.W.C
      • WHO WE ARE
      • Mission, Vision, & Values
      • Privacy Policy
      • Media & Resources
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      • Organizational Services
      • Individual Services
      • Payments
      • Using Insurance
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  • Home
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    • WHO WE ARE
    • Mission, Vision, & Values
    • Privacy Policy
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  • Services
    • Organizational Services
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    • Using Insurance
    • Forms
    • FAQs
    • The Well Shop
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Wallace Wellness Center, LLC

Let us help you facilitate growth and wellness.

Let us help you facilitate growth and wellness.Let us help you facilitate growth and wellness.Let us help you facilitate growth and wellness.

Forms

Contact form

This form is used to gather general information and will be used to help schedule your free intake and maintain correspondence with you.

Complete form

Consent to services

This form is used to obtain your written consent to services.

Complete form

Authorization to Release Information

Though not required, if you wanted another party (friend, family member, entity, etc..) to be engaged with your wellness progress, this form allows us to do so.

Complete form

Self- assessment

 The purpose of a self-assessment is to help an individual know the extent of their abilities and to improve upon them. This information will be used to build your Individualized Wellness Plan.

Complete form

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