PHONE
307-635-3618

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New Patient Forms

Welcome to HealthWorks!

    We are here when you need us.

      To schedule an appointment or for more information please call us at (307) 635-3618.
     If you are experiencing severe symptoms, please call 9-1-1 NOW.



The form below is required if you are applying for our sliding fee scale.  You will also need to schedule an intake appointment to go over the form with our intake staff. 


Click Here For Our Sliding Fee Scale


Full Intake Package - English

Full Intake Package - Spanish


Instructions on how to obtain an IRS Verification of Non-Filing Letter "Click Here"

Link to IRS Form 4506-T



Please Call (307) 635-3618 to schedule an appointment or to get additional information.