You will find on this page
the forms for providing a description of your medical history, important
information for creating effective treatments for your condition, and an
area map of our office. Please download and fill out these forms and bring
them to your first appointment. If you cannot read these forms,
please contact us at 301.228.3764 with your fax number and we will send
them to you.
The first form is for you to
provide your medical history and other factors which are influencing your
for Form #1 .pdf version
Click here for Form #1 Word version
The second form is for people who have Lyme disease (or Lyme and fibromyalgia).
Click here to download and fill out the Lyme Symptoms List .pdf version
The third form is for people who have fibromyalgia.
Click here to download and fill out the Fibromyalgia Symptoms List .pdf version
Once you begin treatment, we will
give you a treatment receipt at the end of each session that you will
submit to your insurance provider to receive reimbursement.
The fourth form is a map of the area
around the Frederick office.
Click here for a map of the Two Frogs Healing Center in Frederick.
Parking is available in the lot behind the center. The entrance is on the left side of Bentz Street. You will see a big elm tree in the center of the lot. Park at any of the red and white signs.
Please use a service like www.mapquest.com to get driving
directions or call us at 301.228.3764.
Now you know about the forms needed
for treatment, please contact us if you have any questions about filling
out these forms at 301.228.3764 or at twofrogshealingcenter @gmail.com.
Click here to return to Contact Us.