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
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.
