Benwell Natural Health

Alternative Medicine & Integrated Wellness Counseling

Medical Forms

Downloadable Forms:

If you are scheduling a consultation or medical massage please complete these two forms and bring them with you to your first visit:

  1. Health Status Form
  2. Insurance Eligibility Form

If you are scheduling a face lifting and drainage service or cellulite reduction service please complete these two forms and bring them with you to your first visit:

  1. Client Information Form
  2. Client Release and After-Care Instructions

The below forms are available in our office:

Massage Therapy Referral Form

Consent to Treatment of Minor Form
 


All patients must take the responsibility to:

  • Give their health care provider and/or health plan the information necessary to provide them with the best possible care;
  • Follow the treatment plan and instructions for care upon which they and their health care provider have agreed;
  • Promptly pay co-payment or co-insurance amounts; and
  • Understand their health problems and participate in developing mutually agreed-upon treatment goals, to the degree possible.
Associated Bodywork & Massage Professionals
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