5 Points Wellness LLC
Offering a better alternative for pain management and preventative healthcare.

Client Forms

Thank you for taking the time to review the online forms.

In order to expedite the process and get you onto the table faster, you may download and fill out the First-time Client Health History Form a head of time,than bring it with you to your first appointment.  I also ask that you download the Cancelation Policy and bring that with you as well. If you are interested in receiving cupping treatments please read over the Cupping Therapy Release Form.

If you are worried about any conditions that you may have or to find out if you are eligible for massage, take a look at the Screening Questionnaire or the Physician's Permission form and consider going over these forms with your Primary Care Physician.

As always, we are here for you, so if you have any questions please call us at 732-528-4561.

In Health,

5 Points Wellness

 

First Time Client Health History Form*
Cancelation Policy*
Screening Questionnaire form -For reviewing with your doctor
Client Feedback form
Physician's Permission form  -For reviewing with your doctor

Cupping Therapy Release Form -For cupping only
Ear Candling Liability Release Form

 

*Required forms for all treatments