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Policies and Forms

Please click on the Blue Buttons for the Office Policy Agreement and Health History Form. First-Time Clients may make a physical copy to handwrite their information, or they may type in their response after making a new copy to email me in advance or print and bring the completed documents to the first appointment. 

The full text of Copper Mountain Manual Therapy Office Policies is shown below for your review. Please click on the title of each document above to open it in a new window. If you are a New Client, please complete your health history and sign our Office Policy Agreement before your first appointment. 

My Requirements of Clients

I respect my time and the time costs of others. Clients are responsible for their appointments and any necessary rescheduling regardless of reminder texts or emails.

  • Reminder Emails/Text Messaging are optional, and clients can opt out upon receipt.

    • 24-hour or greater notice for cancellation will NOT be charged.

    • “No Show” appointments are charged full price

  • Clients will allow for traffic delays in order to arrive on time.Sessions begun late due to the client arriving late are still full price and limited to the minutes booked.

  • If you are more than 10 minutes late without contacting me, you will be charged for that appointment with limited services. Late arrival services will end at the appointment time booked.

    • As a new client, with prior notice of cancellation, you may reschedule.

    • If you miss two appointments without notice services will no longer be offered.

    • Schedule interruptions for health-related recovery and 24-hour or greater notice for cancellation and rescheduling will NOT be charged.

  • Reimbursement for timely canceled and/or unused package sessions will happily be given less applicable credit card fees.

  • A cash, Venmo, or credit card payment is made at the time of scheduling.

  • I do accept Venmo, all major credit cards, including Health Savings Programs and Health Tax Shelter cards. But, I do not file insurance claims. I will remit receipts and a client's records to the client only.

Please come alone to your appointment.

  • Clients are to schedule for themselves, only, and may not “give” their appointments to someone else.

  • Scheduling for dependent minors or attending as caregivers for physical assistance needs are welcome. Please contact me in advance with your child’s name.

  • Parents are encouraged to schedule childcare away from the professional studio unless the child is scheduled for treatment. 

  • All minors must be accompanied by a legal guardian to allow treatment.

Come physically prepared for your appointment

  • DO NOT COME to your appointment if you are ill and contagious. PLEASE CALL AHEAD TO RESCHEDULE without charge.

  • Be clean, having showered the same day as your treatment.

  • Be present (not under the influence of alcohol or drugs.) No smoking on premises.

  • Clients agree to NOT take NSAIDS (ex. Naproxen, Ibuprofen, Aleve, or any other over-the-counter pain relievers or anti-inflammatory aids) within 12 hours of the appointment so that they can be accurately assessed. Acetaminophen is OK.

  • Clients are to avoid massage, physical therapy, or other manual therapy within 24-hours before or after to avoid illness with the release of toxins.

  • Clients must be prepared in advance with their health history and update when there have been any significant events/changes related to their health. Full disclosure of health status is vital to the success of treatments. Dishonesty will terminate services immediately and permanently.

Sexual harassment is not tolerated. If the practitioner's safety is compromised, the session is terminated without reimbursement.

What Clients Can Expect of Me

  1. Clients are treated with respect and dignity. Privacy and confidentiality are maintained at all times.

    • I provide my clients with a competent and professional session each time they come for an appointment, addressing the client’s specific needs for that session.

    • I perform services for which I am qualified and able (physically and emotionally) to do, and I refer clients to appropriate specialists when work is not within my scope of practice and/or not in the client’s best interest.

    • I charge a fair price for my services.

    • I stay current with information and techniques by studying and by completing at least two workshops per year.

    • Clients are clothed at all times during the session. The genitals are never exposed or treated in any way

  2. I only provide my services at my business location. I do not do house calls or treat clients at their businesses, rest homes, rehabilitation centers, or hospitals.

  3. This office does not accept any medical plans or medical insurance.

    • Clients who have open workmen’s compensation cases, who have had an accident that requires litigation or an open insurance claim are encouraged to use those resources to their fullest before coming to my office. It is wise to claim physical pain in all parts of the body as moving pain is part of the healing process and will allow fuller treatment of your injuries. 

    • This office does not submit statements to an insurance company for reimbursement for treatment related to an accident. I suggest that you do not anticipate being reimbursed by your insurance company.

  4. Payment is due at the time of service.

    • I do not provide direct billing for insurance. I do not accept checks from insurance companies. I accept credit cards (Visa/MC/Discover/American Express, including Health Savings Plans and Health Tax Shelter cards).

    • A statement showing payment or my private notes about a session can be sent or given to the client, only.

    • I am not licensed to diagnose. This office does not fill out forms, write letters, or write reports to insurance companies or personal injury attorneys. This is not negotiable; I make no exceptions. I only release client records to the client.

  5. I only cancel appointments in case of an emergency. Should I need to cancel an appointment, I give as much notice as possible.

  6. My equipment and supplies are clean and safe.


By making an appointment you are accepting the rules and conditions of this office,

certifying that you will NOT engage this office in any third-party communications for an open insurance claim (i.e., auto accident, workmen's compensation or an open lawsuit for injuries.) You also certify that you do not intend to sue anyone for injuries. Updated 15 July 2023

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