Patient Forms

New patients will need to have several forms filled out before therapy can begin. To make the process as smooth and efficient as possible, we provide the most important documents as downloads right here on our website.


Find out which forms you need to submit, select the appropriate download link and return the completed documents to our practice either in person, by fax or as a scanned PDF file via e-mail. Naturally, all forms are also available at the practice; however, filling them out in advance saves time.

If you are unsure which forms to fill out, don't hesitate to contact us.

Massage Intake
Massage Intake Form 190519.pdf
Adobe Acrobat document [320.4 KB]
Privacy Form
Adobe Acrobat document [34.7 KB]
Consent Form.pdf
Adobe Acrobat document [33.7 KB]

Note: You will need Adobe(r) Reader(r) to view PDF files. If you do not have it, you can download it for free.

Where to Find Us

Covenant Holistic Therapy

498 West Boughton Road

Suite 202

Bolingbrook, IL 60440 


Phone: (815) 267-6800



Or use our contact form.

Office Hours

Monday - Friday: 9 am to 4:30 pm

Patient Forms

New patient? Save time and reduce the amount of paperwork you have to fill out at your first visit. We provide several patient forms as PDF downloads on our site.

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