Jamie A. Gates

LMT, CCH, RMT

About Jamie Gates Massage
Services Offered
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Frequently Asked Questions
Benefits of Massage
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Contact Jamie Gates Massage

 

Jamie Gates Massage
Crossroads at Fitzwilliam
21 Route 12 South
Suites 5 & 6
(603) 801-1700
info@jamiegatesmassage.com

Client Forms

 

Below are forms that are frequently needed for your appointments. They are all available in PDF format for download.

 

Client Intake Form
If you are coming in for your first appointment, please print and fill out the Client Intake Form.
Click Here to Download

Consent to Treat Minor Form
If you are a minor and are coming in for treatment, please print and fill out the Consent to Treat Minor Form.
Click Here to Download

Health Release Consent for Insurance Carrier
If your appointment is being reimbursed by an insurance provider, please print and fill out the Health Release Consent for Insurance Carrier Form.
Click Here to Download

 

 

 

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