Treatment Forms

To help expedite your registration please complete our Medical Questionnaire, HIPPA Privacy Statement, and Patient Registration Forms and bring them with you to your appointment as required. If you prefer to fill them out in our office please arrive 15 minutes early to your appointment. All forms are available below.

Patient Registration Form: Registration Form
Please download, print. and bring this form to your first appointment.
Also use this form for Insurance information updates or changes in patient information.

Medical Questionnaire: Medical History
Please print, complete and bring this form each time a new injury or symptom occurs.

Privacy Statement (HIPAA): HIPPA Form
Please print and sign and bring this with you to your first appointment.

Physicians Permission Slip: Doctors Permission Slip
If you are being treated at the request of a medical professional this form will allow us to work together.

Client Feedback Form: Client Feedback Form
This is a voluntary short questionnaire about your experience at our facility.

Further information on Body Sage Massage Therapies:

Online Privacy Policy: getform2013

Site Disclaimer: Our Disclaimer

PLEASE NOTE: Workers Compensation Claims will be handled as outlined by the State Of Oregon. We cannot guarantee coverage as there are many mitigating circumstances that could affect a claim. We are always happy to work with you to provide medical massage treatment as recommended by your primary care physician.

Adobe Acrobat Reader is required to view, fill out, and print the forms.

You may download the free application here: Get Adobe Acrobat Reader