Forms

First we want to welcome all new clients at Gentle Wellness Center. Below are the Holistic Questionnaires and a list of all of our services (select and fill out the service you will be receiving). Having all information filled before your visit will save time and allow the therapist and you to go forward with the service scheduled. If you have any questions or concerns regarding an appointment give us a call at (310) 576-6360 or email us at gentlewellnesscenter@gmail.com.

Step 1: All Clients Must Complete the 3 Forms Below:

• HOLISTIC QUESTIONNAIRE

• SB-77

• INFORMED CONSENT

Step 2: Print + Fill Out a form for the service you have scheduled

• COLON HYDROTHERAPY

• BIO ELECTRIC LYMPH DRAINAGE

• FAR INFRARED SAUNA

• IONIC FOOT BATH

• AMETHYST BIO MAT/BELT

Step 3: After filling out your form you may:

• Bring it in on your first visit

• Scan and email it to us at gentlewellnesscenter@gmail.com

• Fax it in at 310.576.0484

**Please write clearly**