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2000 Embarcadero Cove, Suite 400 Oakland, Ca 94606 5105678100 / TTY 5105335018 Karyn L. Dribble, PSD, LCSWIntensive Care Coordination (ICC) Referral Form PLEASE FAX COMPLETED FORM TO 18663138448 Contact
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Visit the Berkeley Wellness Center website or physical location to access the new patient forms.
02
Fill out the required personal information such as name, address, contact information, and insurance details.
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Complete any medical history forms providing details of your past and present health conditions.
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If applicable, sign any consent forms for treatment and release of medical records.
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Double-check all the information you provided for accuracy and completeness before submitting the forms to the staff.

Who needs new berkeley wellness center?

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Individuals who are seeking medical care and wellness services provided by the Berkeley Wellness Center.
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Patients who are new to the center and need to establish themselves as clients by filling out the required paperwork.
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The new berkeley wellness center is a health facility that offers a variety of services focused on promoting overall well-being and healthy lifestyle choices.
Any individual or organization that owns or operates a wellness center in Berkeley is required to file the necessary paperwork for the new berkeley wellness center.
To fill out the new berkeley wellness center paperwork, you will need to provide detailed information about the services offered at your wellness center, the facility's location, and contact information for the responsible party.
The purpose of the new berkeley wellness center is to ensure that health facilities in Berkeley are operating in compliance with local regulations and are providing quality services to the community.
Information that must be reported on the new berkeley wellness center includes details about the services offered, facility location, contact information, and any certifications or licenses held by the wellness center.
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