Intake Forms
Please download and print the PDF forms for Health History and HIPAA. Fill them out and bring them to your first visit so we can focus on your concerns.</P
I designed the Health History form to capture the most important information. This helps me understand your situation so we can work together on the best course of treatment for you.
Health History (PDF) This form covers basic information such as type of pain and other conditions.
HIPAA – Client Copy (PDF) A statement about the privacy of your information.
Minor Consent (PDF) This consent form is required for any work on individuals under the age of 18.