Forms & Payments

Forms & Payments


If you are seeking information about how TeleVine Therapy can assist with your needs, please complete the “General Information” and the “Client Information” forms and we will contact you with further information. Once we receive your information and contact you regarding services, you will be referred to this page again for completion of the remaining required forms prior to your first appointment. Thank you for your cooperation. 


TeleVine Therapy currently accepts payments in either cash or check. 

Please make checks to:
        Tara Helwig Enterprises LLC  

Payment is required at each appointment.