Privacy is very important to us. No information sent to Intensive Therapeutics will in any way be distributed or shared without your acknowledgement and consent.
Instructions to complete registration forms:
- Complete the Contact/Medical information below and submit.
- Complete and sign the following two (2) forms:
Informed Consent Form
Video/Photo Permission Form
- Forms can either be uploaded at the end of this form, mailed to:
Intensive Therapeutics, Inc.
31 Fairfield Avenue
West Caldwell, NJ 07006
OR emailed to: firstname.lastname@example.org
*Forms must be completed, signed, and received at least one month prior to program start.