Forms – Intake Form and Health History

Before your first visit, please print out and complete the forms below (PDF documents).


The first form covers basic legal matters such as giving consent for treatment:
pdf download


The second form covers your health history and current health concerns:
pdf download



* Note: Some health insurance plans cover partial cost of acupuncture treatment.  Please read this page on insurance coverage and call your health insurance provider before your first office visit.

* If possible, please wear comfortable & loose-fitting clothing for your acupuncture appointment.

    Leave a Reply