Intake forms for Emily Klik LMT CST in Wisconsin

Craniosacral Therapy Intake Forms for Emily Klik LMT CST-D in Wisconsin

Including at NorthShore Wellness Collective in Whitefish Bay, WI

and MetaMassage and Bodywork in Shorewood, WI

Please print the following health history form for the scheduled client, you may print directly from the pdf icons below. Then fill out the form and bring with you to your first craniosacral appointment.

*Note: There are different versions of the Client Intake form depending on the client’s age group. For minor clients, parent/ guardian is required to fill out the intake form and accompany minor client to craniosacral therapy sessions.

If you're unable to print the forms in advance, that's perfectly fine!

A blank set will be available for you to complete upon arrival at your appointment.

Filling out the forms ahead of time will help us maximize our session,

allowing more time for CranioSacral Therapy.

Please note this last form (called FYI HIPAA Notice of Privacy Practices) is for your information.

It does not need to be printed and signed for our appointment.

FYI HIPAA Notice of Privacy Practices.pdf