Please fill out your intake forms ahead of time.
Print out your forms, fill them in, and bring them- along with your prescription or referral for massage to your appointment.
In addition to bringing your forms to your appointment, you can also scan and e-mail, fax, or take a legible photo of each page to send to me at:
- email to email@example.com
- photo and text message to 808-285-3009
- fax to 678-696-6671
Forms (2) for ASH Group health insurance reimbursement clients
- Fill out the on-line information form for pre-authorization by scrolling down to the bottom of this page on my site. After I speak with you on the phone, fill out the following intake form.
- Intake Form
Custom Massage Form
- 🌴🌴🌴 Short Intake Form 🌴🌴🌴 (If you are paying out of pocket for a custom massage and have an uncomplicated medical history, you can fill out this abbreviated health form. )
Additional Assessment Forms
- Neck Pain
- Low Back Pain
- Shoulder, Arm, Hand, and other upper extremity pain
- Leg, Foot, and other lower extremity pain