Download Forms

 

  #1 WELCOME LETTER  : Please read the welcome letter first as it provides important information regarding how our clinic functions.  You may wish to print this out for your reference.

Form # 1 Click Here  


#2 INFORMED CONSENT : Please review the informed consent document as it provides important information about possible benefits and side effects of acupuncture and Traditional Chinese Medicine (TCM). Please print and sign this form and bring it with you to your first appointment

Form # 2 Click Here


#3 NEW PATIENT INTAKE FORM AND MEDICAL HISTORY : Please complete this form with as much specificity as possible in order to assist your physician in in recommending the appropriate treatment 

Form # 3 Click Here  


#4 NOTICE OF PRIVACY POLICY AND RECEIPT AND ACKNOWLEDGEMENT OF PRIVACY POLICY: Federal and State regulations require that we provide you with this Notice of Privacy Practices. Please review, sign and bring with you to your appointment. If you would like a copy of this for your records please let us know.

Form # 4 Click Here