A woman with long wavy hair smiling and looking to the side while holding a laptop with both hands. 
download your forms

Client Intake Forms

Three women wearing black shirts with Logo, standing together and smiling against a plain white background.

click the links below to download the forms

fill out the appropriate forms as directed by your provider.

Consent to treat
general consent
Demographic & Medication Intake Form

  • "I cannot express how thankful I am for Flourish Wellness. Hannah is so compassionate and knowledgeable. She really takes the time to listen to your concerns without making you feel rushed. I highly recommend Flourish Wellness to any woman looking for expert, patient centered care."

    —Wendy L

  • "I took a Dutch test with Dr Blankenship and Hannah, perimenopause...no testosterone or progesterone. Blood tests don't always reveal this in depth information. Flourish has been so amazing working with me to get my levels normal. Follow-ups, prescription refills, and just listening to you explain how you feel. Your hormone health is constantly changing and these ladies are equipped to walk the journey with you."

    —Misti L

  • "I went for a consultation, and it was great! Hannah was very thorough, she listened and best of all, did not make me feel crazy!! had bloodwork done and did the Dutch test. I had zero hormones! We discussed treatments, medications, and options. I started taking progesterone and after 3 nights I slept 8 hours! I got a hormone pellet for testosterone and estrogen. Dr. Darcy explained the whole process beforehand, and it was painless. I feel incredible! I feel healthier, stronger and just more like a woman."

    —Julie D