FORMS

New Client Paperwork

If you have not yet scheduled an appointment with one of our therapists please do not fill out the paperwork or send in the billing form. Instead, please Request an Appointment.

 

If you have been directed to this link by a member of our staff, please complete the paperwork below. The NEW CLIENT BILLING FORM should be completed and sent to our secure email at paperwork@integrativeempowerment.com.  Alternatively, you may fax your form to our billers at: f:(734)207-5326. It is important that you include the name of the therapist that you will be seeing. 

 

Please complete the Intake Paperwork and bring a hard copy into your session with your therapist. Thank you and we look forward to working with you!

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Notice of Privacy Practices

Acknowledgement of Receipt of Privacy Practices

​​​Contact Us

122 South Main Street, Suite 200

Ann Arbor, MI 48104

 

2488 Golfside Drive

Ypsilanti, MI 48197

560 S. Main St.

Ann Arbor, MI 48104

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  Tel: 734-945-6210