Request an Appointment

Emergency Assistance

If this is a medical emergency, please call 9-1-1

United States of America: 1-800-SUICIDE (800-784-2433)
Philadelphia Crisis Intervention Hotline: (215)-686-4420

Client Information

First Name

Last Name

Email Address

Primary Phone Number

Are you new to The Intentional Wellness Group?

YES, I am a new client!

Welcome :) Please fill out the TIWG Intake Form(s) and attach them to your appointment request.

NO, I am already a client.

Thank you for choosing The Intentional Wellness Group to walk alongside you through your journey of healing :)

About Your Appointment

Additional Information

If there is anything else you would like me to know prior to your appointment, please include it here

Upload the Intake Form(s) for The Intentional Wellness Group NEW CLIENTS: Please upload the completed Intake form(s) which you can find above.

Add file

Please upload a file

Your information will be encrypted.

LaBreyia Ellis

Licensed Professional Counselor & Owner, The Intentional Wellness Group

LaBreyia Ellis is a Licensed Professional Counselor, has been working with children, adolescents, adults, and families since 2007. She has been providing therapeutic services since 2013.

(610) 379-2322
www.myiwgroup.com
466 Germantown Pike, Lafayette Hill, Pennsylvania, 19444, USA