Client Intake Forms

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815-276-7173

 
Our business name, domain name, and logo are registered, service marked, and legally protected. All rights reserved.
 

For NEW Clients

 
O
nce the date and time of your first appointment has been set, please take the opportunity to print a Client Intake Form. If you complete it in advance and bring it along, you will not have to spend any of your session time on paperwork.
 

Adobe Acrobat Reader is required to view and print the Client Intake Forms. If you do not already have the Free Adobe Acrobat Reader, click on the link below and follow the simple instructions on Adobe’s website:

 

http://www.adobe.com/products/acrobat/readstep2.html



 
Document
Detox Therapy or Energy-Based Therapies
The Client Intake form on the ←LEFT
is for anyone coming to HolEssence for ionSpa® Detox Therapy or energy-based therapies.



 
The Client Intake form on the 
RIGHT →
 is for anyone coming for Acupuncture or Chinese Herbal Therapy.

 

 

It's that simple ... simply print the appropriate form, complete it, and bring it with you to your first appointment. We look forward to seeing you soon.

 

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56 E Crystal Lake Ave, Crystal Lake, IL  60014

 

Webmistress – Laurie Buchanan