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Patient Forms

Please print and fill out the following necessary forms and bring to your first session for review.

1. New Patient Intake

2. Patient Emergency Fact Sheet

3. Information and Consent to Treatment Form

4. The Health Insurance Portability and Accountability Act (HIPPA)

[Right click on each link and select “Save link as…” to save the form to your computer.]

Only sterile, single use disposable FDA approved needles are used in this clinic. Acupressure and non-needling techniques can be used alternatively. See for yourself; the treatments are safe and painless!