• Case History Intake Form​
• Direct Billing Consent Form

Please be aware that depending on how your insurance coverage is set up, payment may only be made to the insurer (you) and be declined to the provider (me). In this case you will have to pay at the time of the appointment and recover the costs from your in
​insurance company.
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• COVID-19 Pre Screening Questionnaire
  The COVID-19 pre-screening questionnaire will be sent to you the day before your appointment. If you provide a positive screening your treatment will be cancelled and rescheduled for a future date. Any "Yes" answers documents a positive screening. Please be truthful on your questionnaire. Any cold or flu like symptoms can be just that...but do not take any chances. You are risking other client's health as well as mine and my families health since this is a home based business.