Intake Form Download

After making your appointment, please take the time to print and complete the Intake Form.pdf version
Intake form Ms word version

1. The Intake form needs to be filled out as completly as possible prior to your Initial visit.

2. The Intake form needs to be filled out as completly as possible if you need to update your medical history.



The Document is an Adobe Acrobat file format. You will need the Adobe Acrobat Reader tm

Use your right-click on your mouse and Click Here to download intake form.(pdf)
Use your right-click on your mouse and Click Here to download intake form.(Ms word)

When the menu drops down, choose "Save Target As" and the file should begin to download.

Open it with Adobe Acrobat reader or Ms word and use the print function to secure a hard copy of the document.

Carefully complete & sign the form and bring it to your appointment.

Thanky you

Marty Austin MS, LMT,CST, NMT, MLD

 
   
   
   
   
   
   
   
   
   
   
   

 

 


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