By submitting above, I agree that all the information I have provided above is true and accurate.  I hereby give True North Athletic Therapy, PLLC and Jaime McCafferty Huestis, MS, ATC, LAT permission to treat musculoskeletal injuries and conditions with therapeutic modalities and/or manual therapy she deems necessary and appropriate as determined within her scope of practice by the NATABOC (National Athletic Trainers Association Board of Certification).

I also understand that any information given to this company is protected with confidentiality and will not be shared under any circumstances without my written consent.