Client Intake Paperwork

/Client Intake Paperwork
Client Intake Paperwork 2018-08-22T17:31:23+00:00

 

Before completing the Client Intake Form, please be sure to review the following:

Client Intake Form

  • In the event that the client is ill, or that the client needs to cancel a session for any reason, the client will contact the MT-BC at least twelve (12) hours prior to the scheduled session time. If you fail to give notice to your therapist, you will be charged a “no-show” fee of $50 for that session. It is understood that there are emergency situations and illnesses that can occur and these situations will be handled on a case to case basis.
  • Our therapists work with medically fragile clients, and we do not want to carry any illnesses to other families, infect ourselves, or our own families. Please cancel your therapy appointment if the client is sick. If your therapist is called or notified about the illness at least 12 hours before your scheduled appointment time, you will not be charged a “no-show” fee for your session. Again, it is understood that there are emergency situations and illnesses that can occur and these situations will be handled on a case to case basis. The Board of Health considers the following signs/symptoms as indications of communicable illness/disease: vomiting, diarrhea, rash/swelling, fever over 100◦, sore throat, red or running eyes. Please be sure you or the client is symptom-free for 24 hours before resuming therapy.
  • Please select only ONE option:
  • Please select only one option: