ADDRESS

4010 Dupont Circle Suite 518
Louisville, KY 40207

PHONE

502-893-2006

New Clients Holistic Questionnaire

Please Note:

New Clients need to complete our intake form:

 

NEW CLIENT INTAKE FORM

To complete the form directly online from any device and submit

Ionic Foot Detox ONLY: Please complete this intake form and bring with you Ion Foot Bath InTake form

IF YOU CHOOSE TO DOWNLOAD THE FORM INSTEAD, USE THESE BOTTOM OPTIONS 

***Download this word document intake form. Once you complete the form email it back to us attaching the document. Our email is: contacthamri@gmail.com

Holistic Questioner – New client intake form

*** Preferred so we can all save trees!

If you choose to print out the form and complete it manually, please download this form below and bring the completed form with you to your first appointment.

Intake form- to be printed

Thank you.