Client Intake Form

If you fill out my intake form,
I can have a much better understanding of your situation.

The intake form links will also be on the the confirmation email once we figure out that date and time.

The more carefully you fill out the form,
the better you and I will understand your situation.

It helps if I receive the form before your session.

Fillable pdf version:

[download fillable client info form] (5.2mb)

1. 1. 1. Fill it out in a non-browser application (Use Preview on a Mac).
    2. –>>Fill out a few lines and do a test save to make sure your info is truly being saved.
      Save your filled out form as a pdf. (Often available as an option in a print dialog box)
    3. Email it back to me as an attachment, to eric@inspiresomatics.com before your session so I can study up.
      Note: Email is not entirely secure. If you email your form to me, that is your decision.
      Do not enter any information that you would only send on a completely secure channel.

-OR-

Printable pdf version:

[download printable client info form]

1. 1. 1. The form will require at least 30-45 minutes to fill out well.
    2. If you don’t have a printer, please let me know. I can mail the form to you.
    3. If filling out the form is a hassle, we still can have a great session without the form.
    4. Please email photos or scans of the completed form to eric@inspiresomatics.com before the session.
      Note: Email is not entirely secure. If you email your form to me, that is your decision.
      Do not enter any information that you would only send on a completely secure channel.

Additional info and images help me to understand:

Photographs are very helpful for me to see some of the patterns that have you in their grip.

Please send photos that show you standing are especially useful. Show Front, Back, and Sides.

Stand relaxed, at ease. Don’t try to stand up straight. Let the tension auto-pilot do what it wants.
Stand as if you were waiting in line for 30 minutes. Give in to the posture it wants you to be in.

Take the photo, with camera approximately at belly button height.
Take the photo standing in front of a door (something rectangular, so I can correct for any distortion from the angle of the camera (parallax error).

Please take the photos with clothes on, please.

If your system likes to stand with your weight more on one leg, include a photo with your weight specifically on the leg that usually posts down straight to hold your weight while your other leg is out/turned to the side.

Please don’t overwhelm me with pages and pages of medical history.

Your history is important, but what’s happening in the present is most important.
I don’t need your entire story, just an abbreviated version of it.
I don’t need to know all your medications. It can be helpful to know what the medications are for.

Please email them to eric@inspiresomatics.com.