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Forms

I realize that at first glance, the forms attached may have the appearance of others that you may have come across before.  So, perhaps, this is the opportunity to begin the change or the shift in this part of your healing, health and wellness journey with Groundswell MFR by taking these first steps together, differently.  Before you begin to complete these forms, I will offer to you some suggestions.  These are only suggestions and when I appreciate your responses, I will be none the wiser of the process you chose to take.  As you set aside a few moments to share this personal information, allow yourself to connect with their images and how these have all influenced and shaped your current state. 


Slow your breathing.


Soften.

So, let us begin at the end, or at least, with the last page of this Intake Form.  And if you are alright with that, continue to work back to the beginning.

 

While some of the information may not seem to be related to the immediate need or present reason that you are here today for treatment, as I apply the John F. Barnes' Myofascial Release Approach, I hold an appreciation for you in your entirety and the connective tissue of fascia that surrounds, supports, infuses, influences and connects every muscle, bone, blood vessel, nerve, tissue, organ, and system (even down to the cellular level) within us.  Everything is connected by our fascia!

  

When you have completed these forms, please feel free to scan, email, or text photographs of the pages to me; and I will pick up the originals with my scheduled visit.


I look forward to our time, with gratitude

-jeff

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