Bodyscapes Acupuncture
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Patient Forms
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Printed Forms
To print your Patient Form out, click "Download File" below. Then print it out, complete it, and bring it with you to your appointment.   Please choose the correct form. Do not email form. Thank you!
New Patient Form - General Acupuncture
Click "Download File" and print your form.
new_patient_form_2016.pdf
File Size: 241 kb
File Type: pdf
Download File


New Patient Form - Fertility (women)
Complete this form if you are coming in
to be treated specifically for fertility issues.
womens_fertility_patient_form_1.pdf
File Size: 274 kb
File Type: pdf
Download File


New Patient Form - Fertility (men)
Complete this form if you are coming in
to be treated specifically for fertility issues.
mens_fertility_patient_form.pdf
File Size: 357 kb
File Type: pdf
Download File


New Patient Form - Facial Rejuvenation
Complete this form if you are coming in to receive Cosmetic Acupuncture (Facial Rejuvenation).
facial_rejuvenation_form_pdf.pdf
File Size: 112 kb
File Type: pdf
Download File


New Patient Form - Massage Therapy
Complete this form if you are only coming in for massage therapy.
1._patient_form_massage.pdf
File Size: 306 kb
File Type: pdf
Download File

Contact/Location
Flossmoor Commons
Professional Building
3235 Vollmer Rd. Ste. 204 
Flossmoor, IL 60422

Phone: :  847.864.6464
Fax: 773.672.7084
bodyscape1987@gmail.com 

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Office Hours
Tuesday - Friday 10:00am-7:00pm
Sunday Morning Yoga, 9:30am-10:45am
Monday: Dance classes 6:30pm-8:45pm.
​Saturday closed.
Office Hours
Tuesday - Friday 10:00am-7:00pm
Sunday Morning Yoga, 9:30am-10:45am
Monday: Dance classes 6:30pm-8:45pm.
​Saturday closed.
​

Amenities
Free consultation with treatment
Discount treatment packages
Online appointment scheduler
All credit cards accepted
Schedule Appointment Online

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  • Home
  • Bio
  • Services
  • Appointment
  • Forms
  • Yoga
  • Gifts
  • Reviews
  • Contact