312 East Dupont Road Suite 101, Fort Wayne, IN 46825    Get Directions

Patient Forms

You may print the following Adobe Acrobat files to fill out and bring with you before your initial visit. Massage therapy or bodywork requires only the Massage Intake form to be completed. For physical therapy please be prepared to fill out all forms except for Massage Intake.

  Patient Registration
  Insurance Information
  Authorization for Treatment
  Commitment to Therapy
  Medical History
  Financial Responsibility
  Bodywork Waiver