Rubato Intake Form

Please download front and back page, print (on one sheet of paper), fill in, and sign.

Intake Form Page 1

 

 

Intake Form Page 2

 

 

 

 

 

 

 

 

Appointments are 1 hour 15 minutes in length, and cost $75. Filling in your intake form completely allows us more time to work on your condition.

Cancellations must be received 24 hours in advance of your appointment, or you must pay for the appointment.

Directions to my office are found on the "Contact Us" page.