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RTC Pain Therapy llc
Rolinda Teller Camacho LMT
4447 East Broadway Rd, Suite 108
Mesa AZ 85206
602-295-3681
Intake forms help give me information about your health history, aches and pains you are experiencing, as well as what you expect from me.
Upon your first visit, arrive 10 minutes early to allow for necessary paperwork or you can print out the forms below and fill out paperwork to bring with you to your appointment.

Click here to print New Client Intake Form
Click here for Minor Liability Release
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