Forms and Policies

Welcome New Clients!

Initial Health History Form
If you are able, please take the time to fill out the information on this health history form, and bring it with you to your first visit.

Equinox Office Policies

TIMELINESS
Sessions begin and end at their scheduled times. I have set your appointment time aside for you to receive my full attention. Please plan to arrive 5 minutes early to enjoy our full visit together! If you arrive early and I am still with another client, have a seat in the lobby and/or use the facilities if needed. If I am at fault for a late session start time, I will honor the original treatment time.

LATE ARRIVAL AND CANCELLATIONS
If you cannot avoid arriving late, please call so I don’t worry about you! We can discuss our options by phone or when you arrive. The appointment will still end at its scheduled time so I can continue with the day’s schedule, and payment for the full session will be expected. Out of respect for Liz’s schedule (and clients on the wait list!) please give 24 hours notice if you are unable to keep your appointment. While I do take real emergencies into account, you are otherwise liable for your full or partial session fee if your session doesn’t get filled, and first offenses are a 50% charge. If you must cancel at the last minute, you can avoid this fee by passing your appointment on to a colleague, friend or family member. You’ll make their day!

SCOPE OF PRACTICE
I will only perform treatments for which I am qualified to do as a licensed massage therapist in the state of Maine. I will refer you to an appropriate specialist when the work you need is not within my scope of practice, or if a more appropriate treatment is indicated.

PAYMENT
Payment is due at the time of treatment. I do not directly bill insurance, but am happy to provide you with a receipt should you decide to seek reimbursement. Cash or Check is the preferred payment method. If you want or need to pay with a debit or credit card, arrangements can be made.

MEDICAL HISTORY AND CONFIDENTIALITY
First time clients will be asked to fill out a 2 page medical history and consent form which will be reviewed and updated as necessary. This and any information shared within my treatment room will always be treated in a private and confidential manner. When you receive treatment you authorize the release of all of your medical records on file in this office for the purpose of processing your claims to the following: your attorney, the healthcare providers attending to this condition, and the insurance case managers. Medical records will not be edited unless otherwise stated in an exclusive release of medical records signed through your attorney. We follow the standards set by the HIPPA laws to ensure your privacy.

ILLNESS
Colds, flu and other contagious diseases are not to be shared! If you do not feel well on the day of your massage, please call immediately and take the time to reschedule. This treatment is not appropriate care for infectious or contagious illness – your body needs to focus full attention on getting well!

INAPPROPRIATE BEHAVIOR
As a Maine licensed massage therapist, I provide only professional services and follow the guidelines, safety rules, and ethics of the law and associated professional organizations. I will conduct myself in a professional manner respecting your boundaries and expect the same from you. I expect that your privacy will be maintained. and will use sheets, towels and/or blankets for your comfort and modesty. Any boundary violations, actions of aggressive or sexual nature, or other inappropriate actions or suggestions of will not be tolerated. I reserve the right to immediately end a treatment session and refuse treatment to any client who violates the boundaries of the therapeutic relationship. Full payment will be expected.

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Contact Info

Email
Cell: 207-240-3857
Home: 207-235-2383
Kingfield
Grand Central Station
244 Main St.
Kingfield, ME 04947