New Client Intake Form
Thank you for filling out this entire page and submitting it to us. We will review your submission and contact you to schedule.
By initiating communication via email or internet contact form and/or responding to an email sent by Shine Integrative Physical Therapy or any of Shine's employees, you are giving consent for initial and continuing communications through these means, while acknowledging potential risks of non-encrypted email communication. You are welcome to print this form and submit them via mail if you prefer.