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Before Your Visit

Please note, we are not accepting new insurance clients as of July 1, 2024. Existing clients can

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Forms are below...

Please print and complete your  Health Intake and Consent Form (below) BEFORE coming to your appointment.  This saves time and reduces physical contact and exposure risk.


Please take the time to carefully review our Clinic Policies, which include a description of what to expect at your appointment (below). 

Insurance?

We are not accepting new insurance clients as of July 1, 2024. 


* For existing clients, Massage Doctor accepts Kaiser, Regence, and personal injury / auto accident cases.  Massage therapy is not covered by Medicare.


** Kaiser patients:  Your doctor must put a referral in their system even if it is not required -- otherwise Kaiser will not pay for your massage. 


As the patient, you are responsible for verifying your benefits and costs prior to you appointment, and to provide a referral if required by your plan. Failure to do so may result in you paying for your visit and seeking reimbursement from your insurer. 


You are financially responsible for your deductible, copay, and/or coinsurance as well as any service charges that your insurance does not cover.


Be sure to fully complete the insurance information in your intake paperwork if you need us to bill your health insurance, personal injury, or auto accident insurance.


Please also note that you must bring your insurance card, driver's license or other photo identification, and (if needed) your doctor's referral and/or prescription to your appointment. 


Please respect other clients and everyone's time.

OUR POLICY FOR 24 HOURS NOTICE:


* If you do not show  for a scheduled appointment without canceling, you will be charged the full fee of the scheduled service.  


* If you cancel with less than 24 hours notice,  you will be charged half the fee of the scheduled service, unless the scheduled time is taken by another client.   


* If you are more than 15 minutes late  for a scheduled appointment, you may be required to reschedule and the rescheduling fee may apply. 


* Payments for cancellations and no-shows are due upon receipt of the invoice.


* There will be a charge for any checks returned due to Non-Sufficient Funds (NSF) per Washington State law (RCW 62A-3-515).  


* We reserve the right to treat each situation on a case-by-case basis. 

Under age 18?

If you are a under age 18, it is Washington State law that a parent or guardian consent for your massage therapy. Please print and complete the Parental Consent form below.

Download forms for your visit

Updated Clinic Policies (pdf)Download
Intake Health Information and Consent Form (pdf)Download
MD No Surprises Notice (pdf)Download

Therapist Use Only

Referral for Massage Therapy (pdf)Download
FRI functional rating (pdf)Download
ROI Release of Information (pdf)Download
Parental Consent for Minors Treatment (pdf)Download
HIPAAPolicy (pdf)Download
Medical Lien Protection Letter form (pdf)Download

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