Wise LIfe Counsel Inc. | Magnolia Yoga and Wellness Center | 111 West Magnolia, # 2004 | Longwood, FL 32750

407-782-0134

Appointment Request

Time For A New Start!
Mary Beth schedules appointments Monday thru Friday with evening times available. Please call or email. Mary Beth will contact you within one business day to schedule an appointment.

If you’re a new client, please complete the following forms and bring them to your first therapy session.

Intake Paperwork [Click Here] Release for Telehealth [Click Here]

If you would like Mary Beth to coordinate care with another provider (for example, your psychiatrist, primary care physician, etc.), complete this form to authorize release of psychotherapy information.

Consent for Release of Confidential Info

Note: To download Adobe Acrobat Reader for free, click here.

Prior to your first appointment:

Please download and complete the forms available on the website. The information you provide will allow Mary Beth to assist you as efficiently as possible. They contain valuable information about the office and policies. Filling the paperwork out ahead of time will give you an opportunity to take your time. If you have any questions you can address them at your first appointment.

On your appointment day:

Please bring the printed and signed forms with you. Mary Beth will be looking forward to meeting you.

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