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815 E. Jackson St. & 835 E Jackson St.
Medford, OR 97504
(Annex located at 835 E. Jackson St.)
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​Contact Us: 541.245.2787 / 541.201.8103 fax
Online Intake Form
Intakes are for scheduled clients only. Please complete at least 2 business days before first appointment.
Client must have already contacted our office to discuss insurance and have a confirmed appointment
with a specific provider.
These are internal documents, and are for the sole use of our office and our scheduled clients.
WELLNESS POLICY: Therapy works best when it is regularly scheduled and attended. However, it is also important that you and your therapist remain healthy. If you have a fever, body aches, or chills in the last 48 hours, please cancel, reschedule, or move to a virtual session. Do not come into the office or waiting room. This policy is to keep you, your community, and your therapist healthy. Thank you.
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