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Appointment Forms

Revised on 12.31.2021
Please download, read and print the files which are marked REQUIRED. All others are optional yet can be extremely helpful in helping us understand important factors in your personal history.
Basic contract and agreement form - Required
Client Information and Contact form - Required
Confidential Information - Optional form - Potentially very Important
Male Sense Chart - Optional form
Female Sense Chart - Optional form
Consent to Touch - Optional form
HIPAA Release Form - REQUIRED to request or transmit information about you to other health professionals
Sliding Scale Chart for INCOME BELOW $74k
Escala de pago para ingresos menores a $74k
COVID-19 Release form - required for ALL in-person appointments
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