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.

Arvigo Therapy Intake Forms

If you are booking your first Argivo® Therapy Session with me please print off the appropriate form and bring the completed form with you to your appointment. 


If this Arvigo® Therapy session will be your first ever appointment with me please also complete the Intake Form above.

Direct Billing Form

If you'd like to set-up direct billing, please print off and return the completed form to the clinic (in person or via email) before your treatment, at least one day prior.


You will only have to do this once, as long as your current policy is in effect. If your insurance policy changes in any way, you will need to fill out a new form and resubmit.

If preferred you may arrive 15 minutes before your treatment to fill in your direct billing form in person.