Anoka Massage & Pain Therapy Intake Forms

New patients, please fill out the appropriate intake form(s) for your appointment type prior to your first visit. When you reach the end of the form, please sign using your mouse or touch screen and click submit.

If you are unable to fill out the form out prior to your session, you will need to arrive 15 minutes early to your appointment to fill the form out in our clinic. If you arrive at your appointment time without a form on file, you may loose time from your session. We can not treat you without an intake form on file. Please plan accordingly.

Should you have questions or need assistance, please call during business hours and we will be happy to assist you. 763.421.2807

Anoka Massage & Pain Therapy Intake Forms:

➣ Massage Intake Form

If we are seeing you for massage, please submit the online massage intake form.

➣ Acupuncture Intake Form

If we are seeing you for acupuncture, please submit the online acupuncture intake form.

➣ Report of Injury

If we are seeing you as a result of a work or auto accident, please submit the online Report of Injury form.

➣ Ear Candling Intake Form

If we are seeing you for ear candling, please submit the online ear candling intake form.

➣ Natural Health Form

If we are seeing you for Wellness Consultation, IonCleanse, BioMat, or Hot House therapies, please submit the online  natural health intake form.