Welcome to Mindful Way Counseling. Whether you are a new or returning client looking to begin a new chapter of care, please complete the intake request form below.
This form helps us understand your unique goals, therapy needs, and insurance information so we can find the best possible therapist match based on current availability. If you are choosing to use insurance, we will need this information to proceed.Â
Watch your email
We will get in touch by email to offer matches for your request. If we do not have a match we will provide you with referral options.
Once your request is submitted, a member of our team will reach out to you soon via email. Please note that completing this form does not guarantee the immediate availability of a specific provider. If we do not currently have an open match for your specific needs, we will gladly provide you with trusted external referrals. Â
Our web form is private and secure. However, this form is monitored by our administrative support team and should not be used for crisis response. If you are experiencing a mental health emergency, please do not fill out this form. Instead call or text 988 for the Suicide & Crisis Lifeline, call 911, or visit your nearest emergency room. You can also visit our Crisis Support Page for additional immediate resources.Â
For minor clients: If you are seeking therapy for a minor- two-parent consent will be required, please scroll to the bottom of this page to review our consent documents that will be required in addition to completing this intake request form. Thank you.Â
If you see a blank blue screen, but haven't hit "submit", scroll up to finish the form.
Are you a parent registering for a new or returning client intake for your child?
- If the minor child's parents have not/never been together or are no longer together (separated/separating, divorced), two parent consent will be required.
- Download the Policies Packet
- Both parents review, complete, and hand-sign each portion of the document
- Send completed forms to: contact@mindfulwaycounseling.org or fax to 612-389-2338.
- Mindful Way can proceed with scheduling an intake appointment, dependent on provider availability at that time, after we have received the hand-signed document from each parent and the new intake request form above.
- Ready to fill out the new intake request form? Scroll back to the form, now.