BEACON WELLNESS ARTS CENTER

CLIENT INTAKE FORM


Before your session, I require that you complete a Client Intake Questionnaire Form.  The questions on this form will help me learn more about you and the specific health concerns that prompted you to choose Chi Nei Tsang as a type of therapeutic treatment. During your initial session, we will spend the first 15 minutes reviewing this form prior to your actual hands-on session.


Click on the button below to download the form.  The form is a PDF form which you can download and save, then manually complete it, scan it, and email it back to me  OR you can click on Fill and Sign in the PDF format to fill in the answers that way.  When you have finished, save the form with your name, e.g. Client Intake Questionnaire - Jane Doe, and then return to me via email at least 1 day before your schedule appointment.