New Patient Intake Form

HIPPA Privacy Form

Physical Therapy Consent Form

You are only required to fill out the above forms if you are a new patient/client. Please send me an email to let me know you have filled this out, as I won’t receive a notification from the site.  If you are a new student to the group classes, you may fill this out optionally so I know more about you, but it is not required.  You will have to sign a consent form at the studio.

If you are a Medicare Beneficiary and are choosing to participate in this cash-pay service, please also fill out this form: ABN Form.

Yoga Consent Form  (New Students, please fill this out and bring with you, or I have them available at the studio)

Important: Complete this document as thoroughly as possible. Some of the questions  may seem unrelated to your condition, but they may play a major role in treatment. All information is strictly confidential.