Thank you for wanting to fill out the Intake Form online.
BEFORE FILLING IN THE FORM BELOW, PLEASE READ…
1. Please fill out paperwork prior to your first acupuncture or massage therapy treatment, or arrive 10 minutes early so that it does not cut into your time.
2. It is expected that you disrobe for your treatment. The only exposure will be the area that is being worked on. This is for comfort and efficiency throughout your treatment.
3. Please arrive for your treatment clean and showered.
4. Please do not wear any perfume for your treatment. Deodorant is okay.
5. The one hour scheduled treatment includes time for paperwork, interviewing and changing sheets.
Thank You!
Please make sure you answer as best you can. Those fields marked with an * are required. If a field is required and you don’t have information to fill in just type in none or n/a.