(505) 906-8048(505) 906-8048(505) 906-8048
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Infinity Dreamscapes Professional Massage Therapy
Brittany R Morris, LMT AMTA CMS

Required Forms

Required Forms are designed to assist towards working together more easily as Healthcare Professionals, and Clients. All Clients must be presented at the time of Schedule Appointment, or you are a Walk-In inquiring for Appointment Scheduling, or Healthcare Professional Referral :

  1. Present 'Required Forms Tab' (Infinity Dreamscapes does not have any Printing Equipment)
    • New Client Forms Required : 
      • New Client Intake Form (Required for Every Treatment Session; Existing Clients Intake Forms will be posted, Temporarily this is required until further notice)
      • General Liability Release Form
      • Intended Health Benefits
      • Minor Liability Release Form (Infant to 17 years old depending on Professional Massage Treatment Scheduled ; Native American Blend Pediatric Cranio Sacral Therapy is up to 7 years old). Forms are Required for Therapeutic, and Deep Tissue.
        • Native American Cupping Therapy Minors will require Healthcare Professional Primary Care Provider or Specialist Annual Clearance Approval Letter (Letter is required Annually) with New Client Intake Forms, General Liability Forms, Intended Health Benefits. Minors will be required to follow up their Healthcare Professional Primary Care Provider or Specialist who submitted Professional Referral
        • Healthcare Professional Primary Care Provider or Specialist who submitted Referral and Annual Clearance Approval Letter must be aware the Minor Liability Release Form is required for every Schedule Massage Therapy Session with New Client Intake Form
    • Existing Client Forms Required :
      • Existing Client Intake Forms (New Client Intake Form Required for Every Treatment Session; Existing Clients Intake Forms will be posted, Temporarily this is required until further notice)
      • General Liability Release Form
      • Intended Health Benefits (Required every 6 months for frequent repeat clients)
      • Minor Liability Release Form (Infant to 17 years old depending on Professional Massage Treatment Scheduled ; Native American Blend Pediatric Cranio Sacral Therapy is up to 7 years old). Forms are Required for Therapeutic, and Deep Tissue.
        • Native American Cupping Therapy Minors will require Healthcare Professional Primary Care Provider or Specialist Annual Clearance Approval Letter (Letter is required Annually) with New Client Intake Forms, General Liability Forms, Intended Health Benefits. Minors will be required to follow up their Healthcare Professional Primary Care Provider or Specialist who submitted Professional Referral
        • Healthcare Professional Primary Care Provider or Specialist who submitted Referral and Annual Clearance Approval Letter must be aware the Minor Liability Release Form is required for every Schedule Massage Therapy Session with New Client Intake Form
    • Corporate Massage Contracts:
      • Subject to Change 
      • Duration Contracts to be determined
      • This 'Required Corporate Contract Form' will be utilized for Workforce Massage Therapy Program (Refer to Navajo Nation Community Services and Events)
      • General Liability Release Form will be required for each employee who are interested in the Workforce Massage Therapy Program
  2. If you are actively consulting with your Healthcare Professional Primary Care Provider or Specialist regarding any Contraindications Listed or Not listed on Infinity Dreamscapes Service, you are required to be present with a Referral Clearance Letter by your Healthcare Professional Primary Care Provider or Specialist and have already consulted with your Healthcare Medical Professional Primary Care Provider or Specialist at the time of Confirmed Appointment. Referral Clearance Letter is Required no matter if your Healthcare Professional Primary Care Provider or Specialist Approved Referral Clearance Letter or if  the Referral Clearance Letter has been Rejected by the Healthcare Professional. (Required Forms are subject to Update) 

 

 

Steps to Submit Required Forms

Walk-in Clients :

On-Site during the Registration Process :

  1. Go to 'Required Documents Link,'
  2. Fill Out Documents
  3. Send Documents to info@infinitydreamscapes.com

                 - Enable 'Confidentiality Mode' 

                           This ensures Privacy Between Client and Business Entity

 

If you are having System Issues submitting the 'Required Documents,' notify Staff Member or Entity Owner

        System will be further reviewed

Required Documents are Required at the time of Appointments.

 

  •  Test Email will only be performed once with 'Enable Confidentiality Mode Active' from a Business Entity Authorized User. If Business Entity Authorized User Personal Information shows on Clients View via Email. Clients are only to hit reply on the designated and authorized Email that was sent out for the Test Email :

         Clients are to immediately notify Business Entity Staff Member or Business Owner

         System Setups will be pending for 'Review Status'

 

Confirmed Book Appointments :

Infinity Dreamscapes prefers Clients to

 

Physically have 'Required Forms,' at the time of Scheduled Appointment Service.

  1. Visit Link : https://www.infinitydreamscapes.com/required-forms
  2. Pre-fill Required Forms
  3. Print Must be Ready for your on-site Scheduled Appointment

** Mandatory 'Required Forms,' must be present at the time of your Appointment. Refrain from making Copies and saving as a, 'PDF' or other methods as It is a Legal Document : Your inquiry for Rendering Services maybe Refused (We have the Right to Refuse Services). Infinity Dreamscapes has Medical Release Forms (Medical Release Forms is required on Obtaining Legal Copies of Documentation; It is just like walking into any Medical Facility (examples: Out-Patient Clinics / In-Patient Hospitals / Emergency Rooms). Medical Facilities will refer you to the Medical Records Department to obtain Legal Documentation. **

 

 

 

 

Location :
Navajo Nation Shopping Center
Infinity Dreamscapes Professional Massage Therapy
NE Corner US HWY 264 Indian Route 12   STE 11-B
Window Rock Arizona 86515

Phone : (505) 906-8048 / (505) 713- 0052
Email : info@infinitydreamscapes.com

 

 

Websites :
https://www.infinitydreamscapes.com/

 

 

Appointment Booking Websites :

https://www.infinitydreamscapes.com/schedule-online

https://www.picktime.com/bf94bddb-676e-470e-9d6c-2969d39d0277#services/service

 

 

Press Ganey :
https://www.doctor.com/Brittany-Morris-596431

 

 

 

 

Affiliation:

Centers for Medicare and Medicaid Services 

 

 

Updated Required Forms : https://www.doctor.com/Brittany-Morris-596431

HIPAA Privacy : https://www.infinitydreamscapes.com/hipaa-privacy

Disclosure Disclaimers : https://www.infinitydreamscapes.com/disclosure-disclaimer

Legal : https://www.infinitydreamscapes.com/legal

 

 

 

 

Infinity Dreamscapes Patient Registration Form

Follow Processing Steps: ** Mandatory 'Required Forms,' must be present at the time of your Appointment. Refrain from making Copies and saving as a, 'PDF' or other methods as It is a Legal Document. : Your inquiry for Rendering Services maybe Refused (We have the Right to Refuse Services). Infinity Dreamscapes has Medical Release Forms (Medical Release Forms is required on Obtaining Legal Copies of Documentation; It is just like walking into any Medical Facility (examples: Out-Patient Clinics / In-Patient Hospitals / Emergency Rooms). Medical Facilities will refer you to the Medical Records Department to obtain Legal Documentation. **

New Client Intake Form

This Form Wlll No Longer Be Acceptable : If you are a new client, please complete this form and bring it along to your first session.

Infinity Dreamscapes General Liability Forms

Follow Processing Steps: ** Mandatory 'Required Forms,' must be present at the time of your Appointment. Refrain from making Copies and saving as a, 'PDF' or other methods as It is a Legal Document. : Your inquiry for Rendering Services maybe Refused (We have the Right to Refuse Services). Infinity Dreamscapes has Medical Release Forms (Medical Release Forms is required on Obtaining Legal Copies of Documentation; It is just like walking into any Medical Facility (examples: Out-Patient Clinics / In-Patient Hospitals / Emergency Rooms). Medical Facilities will refer you to the Medical Records Department to obtain Legal Documentation. **

General Liability Release Form

This Form will be No Longer Acceptable : This is a standard release of liability for our massage therapy work together.

Intended Health Benefits Form

This form will help you clarify your goals for your overall health and vitality, including our time together.

Infinity Dreamscapes Minor Liability Release Forms

Follow Processing Steps: ** Mandatory 'Required Forms,' must be present at the time of your Appointment. Refrain from making Copies and saving as a, 'PDF' or other methods as It is a Legal Document. : Your inquiry for Rendering Services maybe Refused (We have the Right to Refuse Services). Infinity Dreamscapes has Medical Release Forms (Medical Release Forms is required on Obtaining Legal Copies of Documentation; It is just like walking into any Medical Facility (examples: Out-Patient Clinics / In-Patient Hospitals / Emergency Rooms). Medical Facilities will refer you to the Medical Records Department to obtain Legal Documentation. **

Minor Liability Release Form

This Form Will Be No Longer Acceptable : This form allows a parent or legal guardian to give permission to perform massage on a minor client.

Corporate Massage Contract

If you'd like to set up massage for your company as a one-day treat or as a recurring benefit, this contract lays out the details of our agreement.

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