New Clients Health Questionnaire

New Client Health Questionnaire

For all new clients please fill out below the:

MASTER CLIENT FORM TEMPLATE.

Ths detailed Questionnaire Forms were developed from over 34,000 clinical hours case studies.

Upon arrival to First Session, the Practitioner will briefly review the Questionnaire together.

Submit completed form to: JTempower@gmail.com.

Please be sure to Download the Form

first before entering information.

Information entered from website cannot be saved.

2 Additional Options:

1. If Printing then filling in your information please be sure to arrive 5 minutes early so Therapist can review Forms before your Session.

2. Fill in information, Take pictures or screenshots with your phone and send them to 714-588-9465

🛡All Information is 100% Confidential🔒