Take the next step toward healing.

Support is available across Hawaiʻi, in-person and by telehealth at Mindful Living Group.

First Name

Last Name

Phone Number

Email Address *

Date Of Birth *

What are you looking for support with? *

Please share a brief description (for example: anxiety, sleep, focus, life transitions). Please do not include your full medical or trauma history here; we can discuss details with you privately during your intake.

I consent to receive non-marketing text messages from Mindful Living Group LLC with information regarding mental health services, appointment confirmations, intake form follow-ups, and responses to general inquiries. Message frequency may vary, message & data rates may apply. Text HELP for assistance, reply STOP to opt out.

I consent to receive marketing text messages that include information on special offers, workshops and events from Mindful Living Group LLC at the phone number provided. Message frequency may vary. Message & data rates may apply. Text HELP for assistance, reply STOP to opt out.

Please do not include highly sensitive medical details in this form; more detailed information will be collected during your intake. This form is not monitored 24/7 and should not be used for emergencies. If you are experiencing a life‑threatening emergency, call 911 immediately, or for a mental health crisis call or text 988 for support.