Keely Qualey LMT

A Holistic Approach to Chronic Pain & Stress Disorders.

Client Forms

 Keely Qualey LMT

626 Main Road North,

Hampden, Maine 04444


If this is your first appointment please takes a moment to print and fill out the First-time Client Health History form below.  Then don’t forget to bring it with you to your first appointment.  You can, if you prefer fill out a health history form at the office instead   of at home.

First-time Client Health History form
Body Map for Clients
Client Feedback form
Physician's Permission form
Physician's Referral form

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