New Patient Forms

New Patient Forms

New Patient FormsPlease download the set of forms below, and return them to me before your first treatment (if possible).

These forms may seem like a lot of information to fill out before acupuncture treatment, but I offer more than just acupuncture; these questionnaires are my tools to figure out  the root of your problem. I will also treat specific symptoms, but I also want to find the reason why they exist. With the exception of chronic pain, if you choose to only treat the symptoms, you may find the problem returning. (For more information on this topic, visit Functional Medicine.)

All Patients:

Health Questionnaire, Symptoms Checklist, New Patient Information & Consent to Treatment Form

Fertility Patients only:

Fertility Questionnaire