Register

Registration is only required if you do not have a username. Please check your spam & junk mail folders to ensure you have not already received an email with a username and password. If you already have a username log in here

Each account must have a unique email address associated with it. Please contact us if you need multiple accounts with the same email address (i.e. related family members).

Hello Dear Client,

Please fill out the forms, add your contact information, insurance info and credit card and we will add your name to the waiting list. Once everything is complete, your name will be on the "active runway".

I'm looking forward to meeting you, and thanks for registering on the client portal.

Warmly, Suzie

Client Information

Legal First Name / Middle Initial

Last Name

Preferred First Name ( optional )

Pronouns ( optional )

Gender ( optional )

Street Address

Street Address 2

City

State

ZIP Code

Cell Phone ( for Text Message Reminders )
Preferred Contact #

Home Phone
Preferred Contact #

How did you find me?

Emergency Contact

First Name

Last Name

Phone

Mobile

Relation

Street Address

City

State

ZIP Code

Log in Details

( If client is a minor, the legal guardian must enter their email address below. )

Confirm Email

Username
Between 8 and 40 letters and numbers

Suzie Wolfer & Oregon Somatic Therapy - Secure Client Area

Register

Client Information

Emergency Contact

Log in Details