IntakeI information Woman with Pad

Credit Card Authorization

Please take a moment to download the credit card authorization form to your computer. Fill it out, take a picture of it with your cell phone and text it to me prior to your initial appointment. I will ask for your CVV number during that first appointment.

Please  fill out all the forms below, at least 2 days prior to your initial appointment
(be sure and click submit at the bottom of each form)