New Clients

Welcome to Chicago Bodymind Wellness Studio! Please click each link below to download our Intake forms. It will save you time if you bring the completed forms with you to your first appointment. 

At this time we accept Blue Cross Blue Shield PPO and Blue Choice PPO plans. We also accept private payment via Zelle, check, or credit card. 

Please verify your insurance benefits with your insurance company prior to 

New Client Registration

Informed Consent

HIPPA Release Complete this if you have a psychiatrist and/or another therapist that you are working with and are willing to give us permission to be in communication with them.

Credit Card Authorization

Credit Card Consent

(773) 961-7618