Enrollment

Wellness Coaching Enrollment

Complete your intake form and the one combined agreement form below. Everything is completed directly in SRI's secure Google Forms — no account needed.

Selected package

Concierge Wellness Coaching Session

Please note this package name on your intake form so we confirm the right service.

Step 1

Wellness Coaching Intake

Your responses are collected and stored in SRI's secure Google Workspace. This public website does not store your form responses.

Open this form in a new tab

Step 2

Client Agreement & Consents — one combined form

One form covers your service agreement, consents, and appointment/cancellation policy. A link to the full agreement document is below the form.

Open Combined Agreement Form Read the full agreement document

Once your forms are received, you will get an email within 24 hours with your next steps.

Before you pay

Your combined Wellness Coaching Client Agreement & Consents must be completed before your first appointment. If you receive both services, each agreement is tracked and completed separately.
A 25% deposit is required to schedule your service. The remaining balance is due at the time of your service.
No deposit is required for Pathways to Wellness.
Private in-home concierge service is included within a 20-mile radius. Additional charges apply outside the 20-mile service area.
Itemized receipts and supporting documentation may be provided for HSA/FSA or insurance reimbursement purposes when applicable. Providing a receipt or documentation does not guarantee reimbursement or payment. Eligibility and reimbursement are determined solely by your plan, plan administrator or insurer.