index_r1_c1

Forms

To prepare for your first appointment, print out the forms relevant to the services you wish to receive, complete them, and then bring them along to your first appointment.

For all services:

Client/Therapist Agreement (PDF, 78 kb)

For Colon Hydrotherapy sessions:

Health history (PDF, 32 kb)

For all other types of sessions:

Personal Data and Health Screen (PDF, 31 kb)

 

 

6810 Tilden Lane, Rockville, Maryland 20852-4501
301-468-3962 · Fax: 301-984-0218 · Cell: 240-423-3438
Contact me

Copyright © 2005 - 2011 Robert Jordan Health Services