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Wendt Center for Loss & Healing

Wendt Center for Loss & Healing

Rekindling hope. Rebuilding lives.

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Individual Services Agreement

Please carefully review the instructions as well as each form. If you would like to receive a copy of each form, you can do so by inputting an email address.

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Client Services Agreement

for Individual Therapy Services

For each of the four fields below, please click “Add Form” and fill out the form that displays. Once you have added the form, you should see the client/participant’s name and your signature come up. After completing all four forms, you may click submit.

If you are consenting for multiple participants, please refresh your page after submission to complete another form.

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Wendt Center

4201 Connecticut Avenue NW
Suite 300
Washington, DC 20008
Tel: (202) 624-0010
Fax: (202) 624-0062

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