Intake Forms


Please click on the links below so you can print the forms and bring them with you filled out already.  If you don’t bring them with you filled out, you can always fill them out at my office, but I need to know in advance to schedule enough time.   Your treatment time will not be effected.

Only print out the Insurance Intake form if we are billing your insurance (auto, health, workers comp.), but it will be something we will have discussed in advance, as I need to verify coverage.  Otherwise, the Health Intake and HIPAA forms are sufficient.

 

Health Intake (2 pages) (EVERYONE needs to fill this out prior to your first treatment.)

Body Balance HIPAA & Consent (1 page) (Everyone must sign prior to your first treatment.)

Insurance Intake (2 pages)  (You only need this form if we’re billing your insurance, which we MUST discuss prior to your appointment.)

Notice of Privacy Policy (This is only for your edification or records, there is no need to print it for us.)