Craniosacral Therapy Information Request Form Template

Help prospective clients request information about craniosacral therapy by sharing their symptoms, goals, previous bodywork, insurance questions, and interest in a complimentary consultation call.

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About

Many people contact a craniosacral therapist with questions before they book a first session. They want to know whether the therapy suits their symptoms, what to expect, and whether insurance might help. This information request form lets them share that background so the therapist can reply with relevant information and decide whether an initial consultation makes sense.

The form asks for name and contact details, then lets the person select the symptoms or conditions they are dealing with, such as headaches, back pain, TMJ issues, stress, or sleep problems. They describe their main concern or goal, how long symptoms have lasted, whether they have had craniosacral therapy before, which other bodywork they have tried, and any current treatments. Optional questions about how they found the practice, anything else they want to ask, and a wellness newsletter close the form.

Three areas adapt to each answer. People with previous craniosacral therapy experience are asked to describe it. Those who want insurance information can name their provider and plan type, and those who want a complimentary consultation call choose a preferred time of day and days of the week. Anyone who does not need these steps skips them.

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Frequently asked questions

Who is this craniosacral therapy form for?

It is designed for craniosacral therapists, massage and bodywork studios, and integrative wellness clinics. It works as a contact form on a services page or as a reply link for inquiries that arrive by phone or social media.

Does this replace a full client intake form?

No. It is an initial information request that helps you understand why someone is reaching out before a first appointment. Use your full intake and consent paperwork once the client books a session.

How do the insurance questions work?

The form asks whether the person wants information about insurance coverage. If they say yes, it asks for their insurance provider and plan type, which helps you check coverage or explain out-of-network options.

Can I change the list of symptoms?

Yes. Edit the symptom list to reflect the conditions your practice commonly works with and remove any you prefer not to list. Keep a general wellness option for people seeking preventive care.

When do the consultation scheduling questions appear?

Only respondents who want a complimentary consultation call see the preferred time and days questions. Others submit their inquiry without scheduling details.

How should I handle the health details people share?

Symptom and treatment answers are personal, so limit access to the people who respond to inquiries. Explain how you use and store this information in your privacy notice.

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