January 2015

Cancellation Policy We understand that unanticipated events happen occasionally in everyone’s life. In our desire to be effective and fair to all clients, the following policies are honored: 24 hour advance notice is required when cancelling an appointment. This allows the opportunity for someone else to schedule an appointment. If you are unable to give […]

Associated Bodywork & Massage Professionals MEMBER Practitioner/Clinic Name: Veda King Blanchard/Rooted Arts  Contact Information: (862)202-6948; rootedarts@gmail.com Patient Information Patient Name: _________________________________ Date of Birth: ______________ Permission Granted to Provider Name: _______________________________ Specialty/Type of Treatment: ________________________ Reason for Permission There is no reason to believe that massage or bodywork treatments will harm this patient’s progress. However, please

Associated Bodywork & Massage Professionals MEMBER Practitioner/Clinic Name: Veda King Blanchard/Rooted Arts Contact Information: (862)202-6948; rootedarts@gmail.com Client Contact Information Client Name: ___________________________________ Date: ____________ Date of Birth: ____________ Gender: ____________ Address: _________________________________________________________________________ Phone: _______________________________________ Email: ___________________________________ Referred by: ___________________________________ Emergency contact: ____________________________ Phone: ___________________________________ Physician/Health-care Provider name: __________________________ Phone: ____________________ Is this massage/bodywork medically necessary (is it