Patient Forms
Please choose correct form.
Online Form
This form can be completed online (approximately 20 minutes) and should be submitted no less than 24 hours prior to your appointment time. These online forms are powered through Jotform. They are secure and HIPAA compliant.
Printed Forms
If you would prefer to print your form, it must be completed prior to your appointment time. Bring form with you to your appointment. If you do not have access to a printer, arrive 20 minutes early to your appointment. Please do not email form. Thank you!
Please choose correct form.
Online Form
This form can be completed online (approximately 20 minutes) and should be submitted no less than 24 hours prior to your appointment time. These online forms are powered through Jotform. They are secure and HIPAA compliant.
Printed Forms
If you would prefer to print your form, it must be completed prior to your appointment time. Bring form with you to your appointment. If you do not have access to a printer, arrive 20 minutes early to your appointment. Please do not email form. Thank you!
Online Forms - Click button for online form.
Printed Forms - Click "Download File" to print your form.
Printed Forms - Click "Download File" to print your form.
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New Patient Form - Acupuncture
Click "Download File" and print your form. 
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New Patient Form - Fertility (women)
Complete this form if you are coming in to be treated specifically for fertility issues.
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New Patient Form - Fertility (men)
Complete this form if you are coming in to be treated specifically for fertility issues.
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Patient Form - Facial Rejuvenation
Complete this form if you are coming in to receive Cosmetic Acupuncture (Facial Rejuvenation).
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New Patient Form - Massage Therapy
Complete this form if you are only coming in for massage therapy.
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