Session Forms

Please fill out these forms in advance of your appointment to save time.  We separate the different forms that we need based on the service your are signed up for.  Please fill out all appropriate forms.  If anything changes, please update your forms before coming in.  Thanks so much!

***Basic Demographic Intake

Everyone must fill out this form before the first appointment.  Please also see below any other forms you may need to fill out.

Consultation Form (Medical Consults & Wellness Coaching)

This form should be filled out before seeing Dr. LeBlanc or Jennifer Palmer for consults or coaching.

Pain Questionnaire

This form should be used if you are seeing Dr. LeBlanc for pain management.

Detox Therapies Form (Foot Bath, Sauna & Colonic)

Detox Contraindications/Cautions List

This form should be filled out for ionic foot bath, infrared sauna and colon hydrotherapy.  Also, please read the contraindications list in advance of the appointment.

Body Work Form

This form should be filled out for massage, reflexology, shiatsu or craniosacral.

Facial Form

This form should be filled out for all facials

Waxing Form

This form should be filled out for waxing services

Biolight Laser Form

This form should be filled out for Biolight low level light therapy

Friend Referral Form

Print out this form and refer friends to earn money towards your services provided by Nourishing Journey staff

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© 2017-2019. Nourishing Journey. All Rights Reserved.  

Disclaimer: All of the information presented by Nourishing Journey on this website or in any other way are for informational purposes only.  Unless you are consulting our medical staff, we do not prevent, diagnose or treat any disease or disorder.  Please seek appropriate medical care for any health concerns.

8975 Guilford Road, Suite 170, Columbia, MD 21046

410-992-3001