Get Started Ready to get started with HeartMinded? Fill out our questionnaire so that we may better assist you in the scheduling process. Once we receive your information, the intake coordinator will respond within in 24-48 hours via your preferred method of contact. Name * First Name Last Name Email * Phone * (###) ### #### Preferred Contact Method * Email Phone How may we help you? Please share a little bit about your goals/health needs. * How did you hear about us? * Do you prefer your appointments to be held in person or virtually? * In Person Virtually Do you need your appointments on a certain day/time? * Do you have any mobility issues (i.e. difficulty with stair, walking, etc.) * Yes No If scheduling a minor, are you currently co-parenting with your child's other parent/guardian? If so, are both parents aware of the appointment request? * Thank you!
