---

NEW CLIENTS:  To save valuable time at your appointment, it is recommended that you print and complete these forms* at home:

1. * Client Information form
2. * Policies & Payment Agreement
3. Oswetry Disability Index (if you are seeking treatment for pain or injury)

---

Your COMMENTS & SUGGESTIONS are always welcome. 

Client Feedback form

---

Take this form to your physician if you have a PRE-EXISTING MEDICAL CONDITION.  It must be completed and returned to me before you receive massage therapy:

Physician's Permission form

---

These forms are necessary for INSURANCE BILLING or to take a medical deduction for tax purposes.

1. Physician's Referral (Rx) form
2. PIP, Auto Accident, Slip-and-Fall form
3. Worker's Compensation form

---

 Page updated on 25 January 2025