Documents

General Intake Form

Click here to view and download. This form is for new clients, clients who need to update their medical information, and clients who are returning after two years (or more) have passed since their last appointment.

Insurance Receipt

This document is temporarily unavailable for download but please ask me in person if you need a copy. I can also email it to you personally. You only need this form if it’s required by your insurance company or HSA.

I will sign and fill out this form and then you will need to sign it. Some HSAs may also require this. Some companies may require a physician’s referral and signature.

Gift Certificates

Click here to view and download a blank certificate with an all-occasions theme. The information and code for your purchased package or certificate can be written on this.

Click here to view and download a blank certificate with a Christmas theme.