Patient Forms For First Appointment

Print and fill out these 3 forms.  Then, bring them with you on your first visit.

If you prefer not to print them, you can email me at stating “I AGREE TO THE TERMS & CONDITIONS OF THE ATTACHED CONSENT FORMS” and attach the forms to the email.  You might be able to fill out the intake form through Acrobat Reader, open it to “Fill & Sign” and email them back to me.  Thanks!

Acupuncture Intake

Acupuncture Consent

COVID-19 Consent

If you’d like to discuss nutrition, please fill out this 3-day food diary:

3-Day Food Diary


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