Filling out these forms prior to your appointment is appreciated and will save us time when you arrive. If you do not have these filled out prior to your appointment please arrive 15 minutes early for a non-insurance visits and 30 minutes for injury/insurance cases.

New Patient Forms

Please print and fill out the following forms at home. Please allow 15-30 minutes to fill out the forms completely or come in early to fill them out in our office:

• Health Intake (everyone must fill out)
• Auto Injury Information (auto cases only)
• Auto Insurance Medpay Information (auto cases only) -OR- Auto Insurance Information for Self-Pay Only (auto cases only)
  • Click Here to submit your Auto Insurance Information online prior to your appointment (optional)
• Work Injury Information (worker injury cases only)
• Medical Massage Prescription (all insurance cases + for tax write-off purposes)

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More about Referrals/Prescriptions for Massage + Manual Therapy If you need your doctor to write you a prescription for medical massage (all insurance cases must have a referral or prescription dated prior to their first visit with us), please print our Medical Massage Prescription form, have them fill it out and fax it to us (520.448.0819) or you can bring it in on your first appointment. They may also send us a referral from their internal referral system. Prescription/referral must contain diagnosis code(s) and frequency/duration of treatment or state “at therapist’s discretion”.

Workers’ Compensation cases may require pre-authorization for manual therapy. Please contact our office so that we may get authorization approved prior to your first visit.