Printable Forms

Consent Form

If you are a new client or a regular client who has not yet completed our electronic form, please complete the following massage consent form before your appointment.

Massage Consent Form

Direct Billing

Our therapist Helena is the only therapist currently accepting direct billing clients, but forms must be sent prior to your appointment (see below).  If you book with our other therapists, they are happy to provide a receipt so you can make an insurance claim immediately after your treatment.  We can only provide direct bill for the following insurers:

Alberta Blue Cross
Chamber of Commerce
Cowan
Desjardins
Great West Life
Industrial Alliance
Johnson Inc.
Manulife
Maximum Benefit or Johnston Group
Standard Life
Sunlife

Required Forms
– Print & complete the 3 page document and email to bookings@gelousspa.ca prior to your appointment.  If you do not send the forms in prior to your massage (at the very latest the day before your appointment) we will not be able to process your direct bill until your next visit and instead you will be reimbursed by submitting your receipt.  The forms can be found here:

DIRECT BILLING FORM & BENEFIT ASSIGNMENT FORM- CLICK HERE

Direct Bill Process

  1. Prior to booking, please ensure you do not require a Dr. note for a massage as many insurance companies require this on an annual basis and will not reimburse coverage without this.  Your Massage Therapist doesn’t need to see this, it is for your insurance provider’s information only.
  2. Book an appointment online with Helena (she is our only therapist who can currently accept direct billing) and in the comments section please say “direct bill” with the name of your insurer”
  3. Complete the forms http://www.gelousspa.ca/printable-forms/ and email to bookings@gelousspa.ca prior to your appointment (no later than the day before your appointment)
  4. Complete the consent form at http://www.gelousspa.ca/massage-consent-form/ which automatically returns back to us
  5. At your appointment, Helena will direct bill your insurance.

Please note: there is an additional $5.00 fee for direct bill processing.