ACUPUNCTURE HEALTH HISTORY & TREATMENT FORMS
Are you a new patient? If so, please complete and bring the forms below with you to our first appointment. All responses are confidential.
☯ ACUPUNCTURE HEALTH HISTORY FORM
☯ INFORMED CONSENT TO ACUPUNCTURE TREATMENT AND CARE
☯ ACKNOWLEDGMENT OF RECEIPT OF HIPPA PRIVACY NOTICE
☯ ACUPUNCTURE HEALTH HISTORY FORM
☯ INFORMED CONSENT TO ACUPUNCTURE TREATMENT AND CARE
☯ ACKNOWLEDGMENT OF RECEIPT OF HIPPA PRIVACY NOTICE