Forms

Embody Wellness

Enter Virtual Waiting Room For

Dr. Muffley

Embody Wellness icon
Enter Waiting Room

Forms for Embody Wellness: Your Path to Recovery Starts Here

At Embody Wellness, we understand that starting your journey to recovery can be overwhelming. Our addiction medicine services are designed to provide you with the personalized, compassionate care you need to heal. For your convenience, we have made all necessary forms available online. For any questions or further assistance, call our team.


Now accepting NEW patients! Call or text (614) 600-2979 today!

Don't forget about our referral program: refer a new patient and receive a gift card!* Ask Lisa for details.


*mailed out monthly after the referral has been seen

Feel Free to Download, Complete, and Upload the Proper Forms Below

Addiction Telehealth Consent Addiction Treatment Agreement Contract New HIPAA Release New Patient Addiction History New Patient Consent Form New Patient Registration Form Medical Marijuana Form

Request Form