PDF Forms for different massage sessions
Intake Form Press on a BLUE link which will take you to the INTAKE form. This form is designed to fill out online only for your safety based on HIPAA requirements.
All patients must fill out an Intake Form by the law in the United States. This is information that will help us give you the best and safest service we can.
Physician Referral/Prescription Form
Physician Referral/Prescription Form from Authentic Massage Therapy LLC
Confidential Client Intake Form CMS 1500
Authorizing the release of information to the insurance company for billing reasons.
Authorization for Disclosure of Health Information/non prescribed massage therapy clients.
This form needs to be signed by a client if he or she needs to release any information for court, doctors or insurance representatives from Authentic Massage Therapy LLC office.
This form will help us to save your time and help us to better understand where and how intense your pain.
This form will help us to provide safe Prenatal Massage Therapy session. Please print this form, sign and bring to your massage session.
Hot Stone Massage Release Form
If you scheduled for Hot Stone Therapy session you need to print and sign this form prior to your appointment.
All persons under the age of 18 are required to have a parent or guardian fill out this form.
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