intake paperwork

Please download each form under the service for which you are scheduled, print and fill out, and then either scan and email back to us or bring with you to your appointment.* The paperwork will take about 20 - 30 minutes depending on the type of appointment and your health history. You only need to download the Client Notification Form for the therapist with whom you are scheduled. If you have any questions about how to fill out the forms or cannot print them, please call our office at (614) 326-3504.

Lactation Consultation

• Lactation Intake Form

• Infant History

• Maternal History

• HIPAA Electronic Storage Form

• HIPAA Notice of Privacy Practices Form

• Client Notification Form - Alison

• Client Notification Form - Alyssa

Craniosacral therapy, Intuitive Healing, lymphatic drainage therapy, somenos Process work, Pre-Pregnancy or Prenatal Education and support

• CST/Somenos/LDT/Pregnancy/Intuitive Intake Form

• CST & Bodywork Consent Form

• HIPAA Electronic Storage Form

• HIPAA Notice of Privacy Practices Form

• Client Notification Form - Alison

• Client Notification Form - Alyssa

• Client Notification Form - Jessica

BioScan MSA Assessments

• BioScan MSA Intake Form

• BioScan MSA Preparation List

• BioScan MSA Release Form

• BioScan MSA Patient Questionnaire

• Client Notification Form - Jessica

• HIPAA Electronic Storage Form

• HIPAA Notice of Privacy Practices Form