Client Registration Forms

Directions for Completing New Client forms:

  1. Open the New Client form by clicking on the button to the right. This is the only form that you need to complete and return prior to the first appointment (along with a copy of your driver’s license and insurance card).
  2. Save the form on your computer so that you can fill it out. You may also print the blank form and complete it by hand.
  3. Print the form (either blank or filled out)
  4. Please email the completed form to GJB Health Services’ email at or fax it to (920) 560-6618. You may mail it to our office if your session is scheduled for than two weeks in the future:

Mail to:
GJB Health Services
711 North Lynndale Drive, Suite 1-A
Appleton, WI 54914

Please make a copy of your driver’s license and current insurance card (front and back sides). Include the copies when you return the New Client Form.

For In-Person Sessions

Once you arrive at our office for your initial appointment:

  • If you have the necessary forms printed and filled out completely, plan to arrive 15 minutes before your appointment.
  • If you don’t have the completed forms, they will need to be filled out before seeing the provider. Please plan to arrive at least a half hour prior to your first appointment to allow ample time to complete this paperwork.
  • Please bring a current  insurance card and driver’s license to your appointment.  We are looking forward to meeting you!