Clinic Forms

PAPER SUBMISSION FORMS: Print and fill out these forms to speed up the intake process during your first visit.

ONLINE SUBMISSION OF MASSAGE THERAPY FORM:

REFERRAL FORMS AVAILABLE FOR PRIMARY CARE PROVIDERS:

Prescriptions with treatment plans for Massage Therapy are required for all HMA and Regence patients for plans that require authorization.

The following referral forms are available for referring providers.  Primary care providers may be Physicians, Chiropractors,
Naturopathic physicians, Podiatric physicians, Advanced registered nurse practitioners, Physician assistants, Dentists, and Optometrists.  Please check with your insurance plan to confirm who is accepted as a referring provider.

Other forms/informational material of interest: