Intake Forms

Return to my information page.

You are welcome to print out and complete the intake forms before coming in for your appointment. There are two pages. The first page is personal information and medical history and applies to all clients. The second page is specifically for insurance clients.

If are looking at the insurance page, and are confused about what information to provide, just print out the page and bring it with you when you come in for your appointment. It will only take a few minutes to help you complete this portion of our intake process.

Do bring your insurance claims information or health insurance card, so we have the information needed to complete the insurance addendum page.

For your convenience, the forms are provided in both Word and PDF formats. You only need to download one of them.

Click here to download the PDF Intake Form (requires Adobe Acrobat).

Click here to download the WORD Intake Form.