Therapeutic Services Forms
 

To sign up for Therapeutic Services at Furnace Brook Farm, please complete and submit the following forms. You may also print and complete a hard copy of your forms when you come for your first visit to Furnace Brook Farm. Things to note:

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  • Forms may be completed and submitted online. Click the "online" buttons below.

  • Your online form (once completed) may be printed out for your records. Look for the printer icon at the end of each form.

  • If you choose to print your forms, please complete and mail them to: Furnace Brook Farm, 253 Sandy Hill Drive, Marshfield, MA 02050 Attn: Erin Van Steenburgh.

  • Medical information (Step 5) should be mailed to Furnace Brook Farm (whether you complete registration forms online or in print). This information may also be brought with you during your first visit to Furnace Brook Farm.

STEP 1: Therapeutic Services Enrollment

NOTE: Step 1 - Step 4 forms are bundled in the "Click to print forms" option in Step 1.

STEP 2: Medical Treatment Authorization

NOTE: Step 1 - Step 4 forms are bundled in the "Click to print forms" option.

STEP 3: Photos & Publicity Release

NOTE: Step 1 - Step 4 forms are bundled in the "Click to print forms" option.

STEP 4: Liability Release

NOTE: Step 1 - Step 4 forms are bundled in the "Click to print forms" option.

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