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Patient Intake Form

We are proud to offer our patient intake form online for your convenience. The personal information you provide is secure and only used for the purposes of your visit. Speed up the process when you arrive by filling out the form below.

We Care About Our Patients

At Mountain Valley Wellness we care about our patients. We want your visit to our clinic seamless. Help us achieve efficient service by filling out our online intake form before you arrive. Please ensure to provide us with any information regarding your health concerns. If you recently suffered an injury or experience daily pain, please let us know. We will work with any medical limitations you may have. Be sure to let us know if you have any concerns.

Our office is open on weekdays from 9:00am to 5:00pm. If you have any questions outside of office hours, leave us a voice message or fill out our online contact form. Our friendly staff will get back to your answering any questions you may have.