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New Patient Paperwork at The Wellness Connection

Man filling out paperworkAt The Wellness Connection, we offer our paperwork online so you can complete it in the convenience of your own home.

You can easily download and fill out our Patient intake forms on a desktop computer. Please use a desktop PC or Microsoft tablet, as certain smart-phones and tablets do not support filling out PDF files.

Please follow the instructions below:
Step 1

Please read steps 1-4 before getting started.

We are happy to assist you, so if you have questions, please call our office at (636) 978-0970

Step 2

Click the “Download Form” button below.

Our patient intake form will open in a new tab on your browser.


Step 3

Start to fill out all the fields required.

  • Please note that you can adjust the size of the form using the zoom buttons.
  • Click here for a brief video demonstration of how to zoom, save and print the form.
  • Every browser is a little different, the example shown is from a Chrome browser.

Step 4

Once you have filled out the form, please save it to your hard-drive, and send it to us as an email attachment.

  • Our email address is:
  • Or, fax the results to 636-978-7570
  • Or, print it out and bring it with you to your appointment

View a video demo of where to find the zoom, print and save buttons when filling out the form on-line.

Start Your Better Health Journey!

Contact our team today to book your first appointment at The Wellness Connection.

New Patient Paperwork at The Wellness Connection | (636) 978-0970