Root to Crown Healing
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  • Meet Cassie!
  • Therapy Services
    • Race-Based Trauma Services
    • Art Therapy
    • Witch*CRAFT Therapy
    • Groups *coming soon*
  • Coaching Services
  • Abundance Therapy Fund
  • Yoga & Reiki
    • Healing Centered Yoga
    • Reiki *coming soon*
  • Root to Crown Healing Shop
    • Mental Health Inspired Essential Oil Blends
    • Merchandise
    • Mala Beads
  • Events + Workshops
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  • FAQ & Contact
  • Home
  • Meet Cassie!
  • Therapy Services
    • Race-Based Trauma Services
    • Art Therapy
    • Witch*CRAFT Therapy
    • Groups *coming soon*
  • Coaching Services
  • Abundance Therapy Fund
  • Yoga & Reiki
    • Healing Centered Yoga
    • Reiki *coming soon*
  • Root to Crown Healing Shop
    • Mental Health Inspired Essential Oil Blends
    • Merchandise
    • Mala Beads
  • Events + Workshops
  • Pick Your Brain + Professional Consultation
  • FAQ & Contact
Root To Crown
Healing & Wellness

(612) 351 - 0108

New Client Forms

Please refer back to the email you received regarding the specific forms for you to download. 

Pay special attention to which financial agreement form you were instructed to download (full rate, sliding scale, or therapy fund), and complete it with the information specified in the email.

Download the appropriate forms, sign them, and then return them via email (please respond back to the original email you received with the link.)

When I receive the completed forms, you will receive a phone call or email to schedule your intake appointment.

Thank you, and I look forward to meeting you!

​-Cassie

Choose the correct New Client Form Below
2021 Forms
File Size: 288 kb
File Type: pdf
Download File

Sliding Scale 2021 Forms
File Size: 289 kb
File Type: pdf
Download File

Therapy Fund 2021 Forms
File Size: 289 kb
File Type: pdf
Download File

Please also complete the 2 screeners below:
GAD7
File Size: 21 kb
File Type: pdf
Download File

PHQ9
File Size: 443 kb
File Type: pdf
Download File

If you have doctor/psychiatrist/previous therapist/ ETC that I should connect with, please also complete an ROI:
Release of Information
File Size: 206 kb
File Type: pdf
Download File

For existing clients needing to complete their quarterly renewal for Sliding Scale or Therapy Fund rates, please choose the correct document below:
Sliding Scale Renewal Form
File Size: 166 kb
File Type: pdf
Download File

Therapy Fund Renewal Form
File Size: 166 kb
File Type: pdf
Download File

    Symptom Checklist

Submit
 Thank you for Trusting Root to Crown Healing & Wellness with your healing!
  • Home
  • Meet Cassie!
  • Therapy Services
    • Race-Based Trauma Services
    • Art Therapy
    • Witch*CRAFT Therapy
    • Groups *coming soon*
  • Coaching Services
  • Abundance Therapy Fund
  • Yoga & Reiki
    • Healing Centered Yoga
    • Reiki *coming soon*
  • Root to Crown Healing Shop
    • Mental Health Inspired Essential Oil Blends
    • Merchandise
    • Mala Beads
  • Events + Workshops
  • Pick Your Brain + Professional Consultation
  • FAQ & Contact