NEW CLIENT FORMS

 

Please print and complete all forms before your first appointment.

Forms are also available at the office for pickup.

New Client

Information

Personal Information and Health History

Systems

Survey

To help identify all symptoms occurring 

Treatment Consent Form

Consent to treatment and understanding of policies

NRT New Patient Orientation

Information for your records to understand what we do

Lactic Acid

Quiz

A marker for health issues in your body due to stressors

Red Light Sauna Consent Form

Understanding the terms of use of the red light therapy

 

Agreement for Wellness Services

Sherry Lewis D.PSc is a pastoral health and wellness provider, licensed in such capacity by the Pastoral Medical Association (PMA) and are required to provide certain disclosures to you and before providing services, to have on-file an agreement for services that provides clear and specific terms and conditions of the relationship. The Agreement below meets these requirements.

In this Agreement, Sherry Lewis D.PSc is referred to as “Practitioner”, you are referred to as “Client”, the term “Party” refers to an indicated party to the Agreement, and the term “Parties” refers to Practitioner and you jointly.

 

Please read this Agreement carefully and indicate your acceptance of its terms by completing the form. 

(715) 350-8003

©2018 by Whole Body Health, LLC.

1810 Crest View Dr #4a, Hudson, WI 54016, USA