Betsy L Cornell, LMT, NMT
Therapeutic Massage in Clintonville

Client Forms

Print and bring these forms with you to save time at your first appointment:
Health Information Form 

 

A physician's prescription will allow you to receive your massage free of sales tax. The prescription is valid for 1 year. Your doctor may already have a preferred method to prescribe massage, however this form may help: 
Physician's Referral Form

 

If your massage is being paid by a third-party, e.g. insurance, please also provide this form: 
Billing Information Form

Associated Bodywork & Massage Professionals
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