262.483.0163 101W. Main St., Campbellsport, WI 53010

Client Forms

All forms should be completed online prior to your first visit.  If you are unable to fill these forms out online, paper or digital copies will be supplied to you at your first visit, please come at least 30 minutes early to give yourself ample time to fill them out.

Instructions: To fill out the forms online use your mouse to pick a place on the form to begin writing and start typing it's Really Easy.  Make sure you check to the Right hand side of your screen that you completed all the pages of the form prior to pressing "Send to Essence".  If there is an error on your form or you skipped any parts, Essence will email you back to let you know.  The more completely you fill out the forms the better we will be able to serve your needs.  The reason we ask so many questions is so we understand your body the best so we can better serve your needs. Thank you in advance. ~Essence 

All New Essence Patients must complete: (Acupuncture, Massage, Energy Work)

Patient Information Form

Essence Intake Form     If under 18 please fill out the pediatric form Essence Pediatric Intake Form 

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