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Clinton Kyles, CMT

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Client Forms & Waivers

Please Note: All new clients are required to submit a COVID-19 Waiver and Client Intake Form before time of first service.  Forms may be printed or e-signed and emailed.  If you submitted a form via Vagaro Inc. your form has been downloaded and saved in HIPPA compliant format and you do not need to resubmit that form. If you are unsure if your form is on file, please call or email me before booking your next appointment. Thank you for your understanding. 

New Client Intake Form (pdf)

Download

COVID19 Client Waiver PDF (pdf)

Download

Insurance Billing (pdf)

Download

Physician Referral Form (pdf)

Download

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