Patient Forms

We are proud to announce our new online patient intake forms.  You can click the link below and complete most of the new patient paperwork from the comfort of your home.  We offer this option to complete our paperwork online to save you time.  If you would prefer, you are still welcome to come into the office 30 minutes prior to your scheduled appointment and complete these forms utilizing our iPads.

New Patient Forms Link:

Click Here!

New Patient Forms :

Unfortunately, not every form is automated and digitized – yet.  Please check below for any remaining forms that may apply to you.  Again, if not brought with you to the office, we will give you copies upon arrival for your first visit.

All New Patient Forms:

Privacy Policy (only need to read, print if you would like paper copy for YOUR records only)

Privacy Policy Signature Page (to be submitted acknowledging you read the Privacy Policy)

HIPAA Contact and Personal Release

Medicare Patient Forms:

Advanced Beneficiary Notice

Worker’s Compensation Forms:

Responsibility of Payment Form

No-Fault or Auto-Accident Forms:

Assignment of Benefits Form

Massage Therapy Patient Forms:

Massage Therapy Intake Form

Release Form for Cupping

Release Form for Prenatal Massage

Consent Form for Massage of a Minor

If you have any questions along the way, feel free to call the office at 716-580-3577.

 

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