Phone 541-679-0366 l 541-679-4821 Fax
To complete the application download the PDF below.
We have both Adult and Adolescent applications
Please make sure all information on the patient information page is complete and accurate, including insurance and phone numbers.
Please note you will need to have Adobe Acrobat downloaded to be able to fill out applications electronically.
Second Wind Mental Health
11 SW Brantley Dr.
Winston, OR 97496
Once your application has reached our New Patient Coordinator it usually take between 1-2 weeks for a response. Each application is approved by the owner of Second Wind Mental Health. Once approved the application will be assigned for individual providers for approval. When this is done then we will call to set up an appointment if you have been accepted. If we are not able to take you on as a patient we will inform you as soon as possible. Thank you for understanding . ~Second Wind Staff~
We are currently NOT ACCEPTING
NEW Patient Application
Please check back at a later time.