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Health History Form

Hello and thank you for booking!

Before our session together, I kindly ask that you complete the Health History Form on this page and bring it with you to your appointment.

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Fill it out to your comfort level but please know that it will be most helpful for me to understand your health history so that I may deliver treatment in a safe and effective manner.

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Please feel free to contact me if you have any questions or concerns.

Thank you.

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(book here)

The Peaceful Healing Place

1700 E. Algonquin Road

Suite 218

Algonquin, IL 60102

​enter through the doors marked "Professional Suites 201-218"

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847/877-4230

Ninetta Keenan, aobta-cp, bctmb, apce

Certified Practitioner of Classic Asian Medicine,

NCBTMB Board Certified Bodywork Professional, 

NCBTMB Approved Continuing Education Provider

Hours:

Tuesday - 1-8pm

Wednesday - 10am-7pm

Thursday - 10am-8pm

Friday - 1-7pm

Saturday - 10am-4pm

Sunday - call for appt

Monday - call for appt

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Contact

Thanks for submitting!

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© 2024 by Ninetta Keenan

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