Please download and complete the appropriate new patient forms below. All information is kept strictly confidential.
*Please Note: You may be required to fill out more than one of the forms below. If you're not sure which forms apply, please call our clinic and ask. We will be happy to assist you!
Your cooperation in filling out these forms before your first visit will help us to schedule more time for you to spend with the acupuncturist. If you cannot download and fill out these forms, you must arrive at the clinic a half an hour before your scheduled appointment time.
in addition to the New Patient Intake form above.
This is an important tool to determine your fertility quotient.
Patient Intake form above. If you are unsure if your insurance is through ASH, please call our office and we will be happy to assist you in determining your coverage.
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