ESA Telehealth Evaluations


For a telehealth appointment, please complete the following intake forms and email your forms to
Please also include a photo of your government-issued ID in your email. In the subject line, please put "ESA Telehealth Evaluation".
ESA General Consent
ESA Patient History
New Leaf Wellness Center
13347 W Washington Blvd.
Culver City , CA 90066
Phone: 424-201-0611
Office Hours

Get in touch