Form for Autism
Form for General Intake
Medical Consent Form/Contraindications
Healthcare Environment Consent Form
Healthcare Provider Release Form
You can save time at your first appointment by bringing your completed intake and medical consent forms. If your child has special medical needs or recently underwent surgery or other medical procedures I may ask-- after discussing with you about the specifics-- that you discuss pediatric massage with your pediatrician and get their signature before continuing with hands-on work. We can still practice the massage strokes on a doll as things are sorted out and the massage strokes can be easily modified to accommodate your child’s unique needs. If you forget to print out/fill out the forms I will have extra copies on hand.
Forms written by Tina Allen