Restrictions Released Myofascial Therapy
New Patient Information
Patient Forms
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Informed Consent
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Patient Registration
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60 minute session: $115
Longer sessions are available on request.
Payment is expected at the time of treatment. Cash, check, and credit cards (Visa, Mastercard, American Express, Discover) accepted. Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA) can also be used as forms of payment.
Cancellation Policy
Please give at least 24 hours notice if you wish to cancel your appointment. Other patients may be waiting for an appointment. There will be a $50 charge for appointments cancelled with less than 24 hours notice.
Insurance Coverage
In order to provide quality one-on-one care for the entire treatment session, Restrictions Released Myofascial Therapy is not an in-network insurance provider. If your insurance is a Preferred Provider Organization (PPO) you may be able to receive some reimbursement from your insurance provider, however if you have a Health Maintenance Organization (HMO) you would not be able to submit for reimbursement. If you have a PPO we recommend you contact your insurance company to determine the specific details of your plan for seeing an Out-of-Network Physical Therapist. Some plans many require you meet an out-of-network deductible and only reimburse a percentage of the cost. If you do have out-of-network coverage you would pay for the full cost of the session at the time of service and then you would receive a bill from Restrictions Released Myofascial Therapy to submit to your insurance company for reimbursement. We can discuss this further during your first visit if you plan to seek reimbursement from your insurance company.
Flexible Spending Account (FSA)
An FSA is a financial account that can be set up through a cafeteria plan of an employer, where the employee can designate pre-tax dollars to be put towards medical expenses. If you would like to submit a receipt to your FSA please request a bill for services.
What to Bring
  1. Completed intake forms
    Download the forms above. If you are unable to complete new patient forms in advance please arrive 10 minutes prior to your scheduled appointment to complete them in our office.
  2. What to wear
    The nature of fascial restrictions is a whole body problem so we treat whole body. In order to fully assess posture and treat all of the areas of fascial restriction it is important to have much of the body exposed. Men please wear or bring gym shorts. Women please bring gym shorts and regular bra or tank top.
  3. What not to wear
    Please do not wear any body lotion the day of your session. In order to receive the most benefit from the therapy your skin must be clean and dry to allow the therapist to properly access your fascial system.
  4. Camera/camera phone
    Some patients like to take before and after pictures of their posture to document their progress. Some patients also like to have photos or videos of themselves performing the self treatment exercises as a reminder on how to properly do them when at home.
What to Expect
Your first appointment will consist of a Physical Therapy evaluation which will take approximately 30 minutes and the remaining time will be hands-on treatment. Once it is determined where your fascial restrictions are, you will be instructed on some self treatment exercises. Patients will be given small balls to assist them in releasing the fascia at home. Self treatment is a very important part of the treatment plan. It is also important to drink plenty of water after your session, this will help the releases to last longer.
It is strongly recommended that new patients schedule at least 3 sessions (once a week for 3 weeks). Three sessions are needed to begin a proper treatment plan. Most patients will see some results after the third session.
Prescriptions for Physical Therapy
Under Massachusetts state law Physical Therapists are granted direct access to patients. You do not need a prescription from a doctor to see a physical therapist. However your insurance company may require a prescription if you plan to submit a bill for reimbursement.