Acupuncture Works Center

Helpful Forms

The following forms are designed to help us work together more easily. On an initial office visit a person would fill out all three of these forms. This will give me a clear picture of not just the "problem" but of your constitiution in Chinese Medicine. 

Intake Form A front

Intake Form A front

Intake Form A back

Intake Form A back

Welcome Sheet back

Welcome Sheet back

Consent to treat

Consent to treatment

attest form

attest form

Welcome Sheet front

Welcome Sheet front

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