Minor Client Intake Packet

All forms must be completed prior to session.

For minor clients (under age 18), forms must be completed by the minor's legal parent/ guardian.


For minors of divorced parents, BOTH parents regardless of conservatorship, must complete a separate intake packet for each minor client. A complete copy of the divorce decree is also required prior to first session.

The security of your information is important to us. Our forms utilize end-to-end encryption and HIPAA-compliant technology. 

As such, your answers will not be saved until all required fields are completed & submitted. Guardians, please allow yourself about 20 minutes to complete these forms. 

If you're unsure how to answer a question, simply type 'unsure' and continue. 


The Vine Wellness Group

14802 Jones Maltsberger Rd #1101, San Antonio, TX 78247, USA

17080 HWY 46 #109 Spring Branch, TX 78070, USA


(210) 490-4419

©2020 by The Vine Wellness Group