Intake Forms

Hello,

These forms are provided to help save you time in the office. If you are coming in for acupuncture, you need to print and fill out just the first four forms. You would only need to print and fill out the Authorization to Release Health Information form if you need us to communicate with your other health care providers. If you are an Online Herbal Consultation patient, the last form is all you need to print and fill out.

Thank you.

Notice of Privacy Practices *(Read only. You do not need to print.)