REGINA RICHARDSON CMT, MSOM, BCTMB

Ancient Therapy for Modern Times

Client Forms

Please complete the first form, prior to your initial session. 

 

  1. Health Information
  2. Screening Questionnaire
  3. Body Map for Clients
  4. Health Status Update
  5. Client Feedback    
  6. Physician's Permission
  7. Physician's Referral 
  8. Billing Information