Click button below to download appropriate forms.

When direct billing a credit card is required!  No Exceptions!

The coverage & requirements of your plan is your responsibility please bring all that is required for your claim to ensure approval.

The form above is required by the program that I use to directly send the billing information.

Gift Certificates & Packages

Standard form required for all to fill out.

The form above gives me permission to direct bill your insurance provider for the services rendered

General Forms

Here to provide top quality massage therapy you need and deserve!

​Daniel J. Fevreau, RMT

Relax and Enjoy.

  • Packages must be used within 1 year of purchase, after which the remaining balance becomes a gift card and the package pricing no longer applies.
  • Packages are Single person use only.
  • Packages cannot be combined with other offers or discounts.

Direct Billing Forms

Copyright 2013. Daniel J. Fevreau, RMT. All Rights Reserved.

These forms are ONLY needed for Direct billing.