REGINA RICHARDSON CMT, MSOM, BCTMB

Ancient Therapy for Modern Times with Complementary & Alternative Medicine

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