Terms and Conditions

 

I understand that the services provided are for general health, as well as relief from pain and/or stress. I understand that the person providing these services does not diagnose illness or disease and does not prescribe medical treatment or pharmaceuticals, nor are spinal manipulation's part of these services. I understand that these services are not a substitute for medical care, and  it is recommended that I work with my primary caregiver for any condition I may have. I have stated all my known physical conditions and medications, and I will keep the provider updated on any changes.

 

 

I understand that showing up late for an appointment will affect the duration of my session, as the provider cannot run over into the following scheduled session. I understand that I will still be responsible for paying the full price of the scheduled time in the event that I am late.  

 

 

Please give at least 24 hours notice for all cancellations.  Any cancellation with less than 24 hour notice will result in a charge for half of the session price.  Any cancellation with less than 2 hours notice, or no-show for appointment will result in a charge for the full price of the session.  

Intake/Consent Forms

CLICK HERE for a printable PDF Consent form

 

Please fill out the online intake form below, or if you prefer, you can CLICK HERE for a printable PDF intake form.                     

Name *
Name
Address *
Address
Home Phone
Home Phone
Cell Phone
Cell Phone
Do you currently have, or have a history of any of the following conditions?
How Often?
Check all that apply