This is my Prescription / Referral form that I have created for clients who have been involved in an automotive accident or have sustained an injury on the job and are looking to have their Massage sessions covered by an insurance company. This form must be printed and filled out by your Medical Doctor, a Physician or by a Chiropractor. This form can be brought in on the day of the first Massage post accident.
I will also need some additional information for billing purposes prior to the first appointment. So please have all information available when you contact me to schedule your appointment.