Forms

formsWe are committed to you having the best customer experience at Awaken Wellness and our practitioners are dedicated to fully addressing your concerns and health goals. In order to fulfill on this we request that you complete the appropriate form(s) below before arriving for your first visit.

Acupuncture
Payments by Insurance
New Patient Intake Form

Insurance Billing Authorization Form

Payment by Patient
New Patient Intake Form

Free Consultation Form
Acupuncture Free Consult


Chinese Herbal Medicine
New Patient Chinese Herbal Medicine Forms


Massage Therapy
New Client Massage Therapy Forms
New Client Fertility Massage Forms


Yoga & Wellness
Yoga & Wellness Class Consent

New Client Yoga Therapy Forms
Yoga Therapy Free Consult

Memberships and Packages
Massage Membership Terms and Conditions
Yoga Membership Terms and Conditions
Package Plan Purchase Agreement
Massage Membership Cancellation Form
Yoga Membership Cancellation Form


Holistic Health Coaching

New Client Forms Holistic Health Coaching

Thermography
New Patient Thermography Forms

Common Forms
Notice of Privacy Practices HIPPA
Record Release Form
Insurance Billing Authorization Form
Update Information for Patients not seen in 1 Year or more