Forms

Life Wellness Center is happy to provide Lakeville with the best customer service in town. In order to make sure that your appointment goes as scheduled, make sure to have your paperwork filled out and ready beforehand. Find the paperwork associated with the reason for your visit below. If you have any questions regarding the forms, feel free to contact our office and we will do our best to assist you.

If you are a new or existing patient, please download and complete the appropriate form(s) below.

Please bring the completed form(s) to your scheduled appointment:

• New Patient Health Information Form
• Updated History Form
• Motor Vehicle Collision Form
• Personal Injury Verification Form
• Insurance Questionnaire/Benefits Verification Form
• Worker’s Compensation Verification Form
• Worker’s Compensation Questionnaire Form
• Patient Responsibility Form
• Credit Card Authorization Form

Massage Therapy Clients:

New Massage Therapy Intake

Ideal Protein Clients:

Ideal Protein Health Profile