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PATIENT INTAKE FORM

Thank you for choosing to embark on this journey with My Walk of Life Inc. Before we dive in, we’d love to learn a bit more about you so that we can see how we can best assist your needs. Please take a few moments to complete this brief form. Your responses will help us understand your preferences, goals, and the best ways we can support you. By sharing this information, we can assess which services are best for you.

Birthday
Month
Day
Year
Gender Identity
Education Level
Racial Identity
Employment Status
Household Size
Marital Status
Household Income
HELPING THOSE IN NEED 

The My Walk of Life Family is comprised of passionate Professionals and Community Advocates who share the same passion and vision toward helping individuals and families gain Financial Clarity & Confidence, Develop a Healthier Money Mindset, and Plan for Long-Term Success. We believe that your finances should be the Source of your Strength, not the Source of your Stress. 

Financial and Mental Wellness is important you can make a difference today by donating!

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OUR PARTNERS

My Walk of Life core mission is aligned with Community Collaboration and our Community Partnerships are essential to our organization fulfilling its desired goals. Our community partners include but are not limited to health care and mental health providers, social service agencies, non-profits, faith-based organizations, and other organizations or individuals who share the same visions and passion as we do. Meet our most valued Community Partners

ABOUT US
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150 Oakland Ave. Ste 229 

Rock Hill SC 29730

RESOURCES

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