Forms and first visit

Lael Evans LMP
Licensed Massage Practitioner

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Please arrive about 10-15 minutes early for your first visit. This allows time for necessary paperwork, and a health history interview. I will always try to give you the full amount of hands-on time for the actual therapy session. Medical claim interviews sometimes take a little longer. For your convenience you may download, print, and fill out the forms you will need and bring them with you. (If you can't, no worries, I'll have copies.)

All new clients need the Health Information Form

If you are using private insurance, you will need two forms: The Private Insurance form and the Private Insurance Verification form. Please have all requested information, including the amount of your co-pay, your doctor's name, phone, address, and written prescription or referral. If you need assistance in filling these out, please contact me.

For an automobile injury (personal injury claim) please fill out the Auto Accident Insurance Information form.

If you are using a Labor and Industries claim for work-related injuries, please fill out the Worker's Injury Insurance Information form.

Massage therapy forms

Health Information Form
Using private insurance? Please fill out these two forms:
- Private Health Insurance Information Form
- Patient Private Health Insurance Verification Form
Automobile Personal Injury Form
Labor and Industries (Worker's Injury) Claim Form