215-340-3930

Well of Life Center for Holistic Healthcare

215-340-3930

CFT Intake Form

New Client Appointment Checklist

5

Fill out paperwork completely

5

Drink plenty of water prior to your session

5
No makeup, perfume, lotions, or deodorants
5

Eat 2 hours prior to appointment

5
Complete and submit form below

These guidelines are in place for your protection and ours, as we strive to serve you to the best of our ability.

Please understand the importance of keeping your appointments. We do have a 24 hour cancellation policy that is strictly enforced.

Please contact our Client Advocate if you have any questions or need additional information.

New Client Form

CLIENT INFORMATION

TRAUMAS/INJURIES:

CHILDBIRTH:

YOUR BIRTH:

CLIENT CONSENT

Please click HERE to read our Agreement and Release of Liability. Then, sign by typing your full name in the box above. By signing, you are acknowledging that you have read and accept the terms and conditions of the Agreement and Release of Liability.

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