Call for more info:
801.689.2546
To make an appointment:
Schedule online now
Find a PRT Practitioner

Patient Information Forms

Please fill out the following forms to the best of your abilities. For the medical history information, such as heart attacks, etc., please indicate whether you are or a relative have suffered from the ailment.

Service Agreement and Patient Privacy

  • Click here for Service Agreement Form (please print, fill out and bring to your appointment)
  • Click here for Patient Privacy Form (please print, fill out and bring to your appointment)
© 2009-2017. All rights reserved. Positional Release Therapy Institute. 1702 E. 5600 S. Ogden, UT 84403
Positional Release Therapy Training and Clinical Practice in South Ogden Utah (UT)
Palm Tree Creative