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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.

client agreement 2020-r01.pdf

Basic contract and agreement form - Required

Client Info Sheet.pdf

Client Information and Contact form - Required

client confidential information.pdf

Confidential Information - Optional form - Potentially very Important

male sense chart.pdf

Male Sense Chart - Optional form

female sense chart.pdf

Female Sense Chart - Optional form

consent to touch.pdf

Consent to Touch - Optional form

Templates PDF.pdf

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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