Holly Glennon RN, BSN, LMP, Certified Reflexologist (360) 528-0683

The following forms are designed to help us work together more easily. Please take a moment, print out the form(s), fill out the information and bring them to your first visit.

Reflexology Session = Reflexology Intake form + Authorization and financial form

Acupressure / Massage Session = Intake form + Authorization and financial form

Prenatal Visit (Pregnancy related visit) = Pregnancy Intake form + Authorization and financial form

Reflexology Form

Reflexology Intake Form

Intake Form

Acupressure / Massage form

Prenatal Intake Form

Pregnancy Session Form

Authorization and Financial Form

Insurance Form

Note: To download Adobe Acrobat Reader for free, click here.