Prospective clients and returning clients should request an appointment by completing the form below:

Anyone wanting an intake appointment must complete this form in order to be scheduled. This form requests your insurance information, which you will need to provide, if you are choosing to use insurance.

Once completed, someone will get back to you soon via email. 

Please note that our forms and website are private and secure.

If you are looking for our Important Signatures and Consent form for minors of parents who are not together, scroll to the bottom of the page for the documents you need. 

Please do not fill this out in cases of emergency. If you are experiencing a crisis, please see our Crisis Information. This form is submitted to administrative support team who cannot provide crisis response. In an emergency or crisis, please call or text 988, call 911, or visit your local emergency room.

Are you a parent registering for a new client intake for your child? If the child’s parents have not/never been together or are no longer together (separated/separating, divorced), Mindful Way Counseling, LLC, requires hand signatures on the “Important Signatures Consent form PDF fillable” document by both parents prior to scheduling any intake appointments. Please download the policies for your review and the important signatures consent form to be completed and hand signed and initialed by both parents. You may send the completed forms to contact@mindfulwaycounseling.org, fax to 612-389-2338, or mail to 1250 Moore Lake Dr E ste 152, Fridley, MN 55432. Once we have received the signed document we can proceed with scheduling your intake appointment, dependent on clinician availability, at that time. Please make sure that you have also completed the form above so that we have information associated with the consent form or we will not be able to proceed with any communications or scheduling after receiving your form. Thank you.