Whipped Zen Wellness
Healthy Hands That Help You Feel Better

Client Forms

Please print and fill out Health Information form and Screening Questionnaire form before coming in for your massage session. This information will assist me in helping you getting healthier!

Health Information form
Screening Questionnaire form
Health Status Update form

 

I follow HIPAA Privacy Rules

The HIPAA Privacy Rule is:

The HIPAA Privacy Rule establishes national standards to protect individuals’ medical records and other personal health information and applies to health plans, health care clearinghouses, and those health care providers that conduct certain health care transactions electronically.  The Rule requires appropriate safeguards to protect the privacy of personal health information, and sets limits and conditions on the uses and disclosures that may be made of such information without patient authorization. The Rule also gives patients rights over their health information, including rights to examine and obtain a copy of their health records, and to request corrections.