Welcome to the
Forms Page
When scheduling your appointment, you will be prompted to submit the required forms. These forms can be uploaded directly during the scheduling process for your convenience. They ensure we have all the necessary information to provide the best possible support for your health journey. Below, you'll find the forms categorized by whether you are a new or existing client.
How to Submit Forms
Click the form picture to download the form or fill it out online.
Complete and submit the forms at the time of scheduling your appointment or via email at “thisisregenesis@gmail.com”.
Ensure all required forms are submitted to avoid delays in your session.
New Client Forms
Client Intake Form
Provides an overview of your health history and key concerns.
Consent to Services
Outlines the scope of services offered and ensures mutual understanding.
Terms of Services
Details policies, including payments, cancellations, and other terms.
Herxheimer and Symptom Fluctuations Disclaimer
Explains potential reactions during the healing process and how to respond.
Highlights your active role in the
healing journey.
Personal Responsibility Statement
Membership Agreement
(if applicable)
For clients enrolling in a membership program, this form outlines membership benefits, terms, and policies.
If you’re a returning client, you may need to complete:
Authorization to Share Information
Allows us to collaborate with other professionals or share your information with designated individuals as needed.