Forms

Fill out forms PRIOR TO YOUR PHONE APPOINTMENT and submit them by mail or via email. Scroll down for the forms.

First Time Clients

Complete and submit the following before your first phone consultation:

  • Health Intake Form
  • Consent to Bodywork during COVID-19 Pandemic Form
  • OPTIONAL: Permission to charge card on file

Returning Clients

Complete and submit the following before your first phone consultation since my re-opening:

  • Consent to Bodywork during COVID-19 Pandemic Form
  • OPTIONAL: Permission to charge card on file

FORMS

PRINT OR DOWNLOAD CONSENT FORM HERE

PRINT HEALTH INTAKE FORM HERE

FILL-IN HEALTH INTAKE FORM HERE

PRINT CREDIT CARD AUTHORIZATION FORM HERE

Submitting your completed form(s):

  • Print the form(s) or fill it out on your computer.
  • Sign, initial (as needed) and date the form(s).
  • Submit a hard copy by mail, or email the completed form to patricia(at)befluidbodywork.com.*

*My email account is fully compliant with healthcare privacy rules (HIPAA), but yours may not be. Email at your own risk.


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