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Intake Form

If you are a new client please print off, complete, and sign the following health history and consent form before your treatment.

Children under 18 years of age will require a parent or guardians signature on the completed form before their treatment.

 If you prefer, you are welcome to arrive to your appointment 10 minutes early to fill out the intake form at the clinic.

New Intake Form Coming Soon

Arvigo Therapy Intake Forms

If you are booking with me for Argivo® Therapy and have not had an Arvigo Therapy treatment  with me before, please indicate this on the online intake form so I may email you a copy of the electronic intake form. 


Direct Billing

Direct billing is available.

Upon booking an appointment you will receive an online intake form. If you would like to set up direct billing with me, please indicate this on the form in the area provided.

Currently Not Accepting New Clients

If you would like to be added to my new client wait-list, please fill out the contact form below.

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