Hello [ClientFirstName],

This is Pelvic Wellness Center reaching out because you either contacted us or we received a referral from your provider.

Please note:  We are in network with PacificSource and Providence Health  Regrettably, we no longer are able to accept Medicare, Medicare Advantage or Medicaid plans.  

If you have other insurance and/or would like to pay out of pocket,  please contact us via text or phone 541.515.6215 and you can bypass this step.  Instead, we will send you all of the forms and then you can simply schedule your own appointments. 

Otherwise,  please complete this brief form so I  have some information to start our conversation and check your insurance benefits.

After you submit the form you will be directed to schedule your Free 10 min Phone Consult (Do not click on "Sign Out" after about 10 seconds you will automatically  transfer you to the booking site)

Simply copy the red password below then open the form and insert the password to get started.

Please call or text 541.515.6215 if you have any questions.

You can also visit our website for more info: https://eugene.pelvicwellnesscenter.com

I look forward to talking with you soon.

[IntakeQLink]

Judy Abel, PT