High Level Health & Wellness Center | Orlando, FL 32818
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    • BOOSTED TURMERIC
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Printable Forms

New Client Forms

If you're a new client, please complete the following forms and bring them to your first therapy session.
Client Intake Form
File Size: 75 kb
File Type: pdf
Download File

Limits of Confidentiality/Cancellations
File Size: 71 kb
File Type: pdf
Download File

Current Client Forms

If you would like me to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information:
Authorization to Disclose
File Size: 2382 kb
File Type: pdf
Download File

Note: To download Adobe Acrobat Reader for free, click here.
Contact Us
High Level
Health & Wellness Center

6399 W Colonial Dr,
Orlando, FL 32818
​

Phone: (407) 668-6025
​
verbeniasousa@yahoo.com​​

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highlevelhealthcenter@
​yahoo.com

Contact Us

High Level Wellness Center
6399 W Colonial Dr,
Orlando, FL 32818
​
Picture
Phone: 
(407) 668-6025
​(407-985-2498
  • Home
  • About
    • Philosophy
    • Meet Our Team
    • Tour Our Office
    • Rates
    • Privacy Policy
    • Disclaimer
  • Services
    • BOOSTED TURMERIC
    • 21 DAYS DETOX CHALLENGE
    • Acupuncture
    • Clinical Psychology
    • Exercise
    • Guided Imagery & Relaxation
    • Holistic Nutrition
    • Herbal Remedies
    • Massage Therapy
    • Meditation
    • Reflexology
  • Resources
    • Printable Forms
    • What To Expect
    • Helpful Links
    • Common Questions
    • Helpful Books
    • Blog
  • Book Appointment
  • Contact
    • Connect With Us