Forms

Underneath you will find Forms to Download if you wish to have them, printed and filled out before your session.

Some of them take some time to fill out as they are comprehensive.

Please read all descriptions and make sure you get all the forms you need

They contain medical question pertaining to you and your health, please fill out to the best of your knowledge

We are HIPAA Compliant 

Cancer survivors in-treatment or in recent-recovery (6 month after last treatment date) as well as patients with lymphdema have to get a physicians release form signed and bring that for your first appointment here.

Long term survivors do not need a physicians release form signed

Simply click the icon next to the text for the files you need

If you are experiencing problems with the forms, you can email us miechellecmt@gmail.com and we will send you the form by email.

Massage Intake

Standard Intake Form

Should be filled out by ALL clients

Oncology Massage Intake

Oncology Intake Form

Should be filled out if you are a Cancer survivor

In-treatment

Recent Recovery

Long Term Survivor

Lymphedema Intake

Lymphedema Intake Form

Should be filled out if you have Lymphedema in one, or more areas

Physicians Release

Physicians Release Form

Should be filled out by Lymphedema Patients and Cancer survivors, in-treatment or recent-recovery

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