Registration & New Patient Forms

• Practice Policies
• New Patient Forms (includes practice policies, email policy, HIPAA privacy notice, release of records, registration form)
• New Patient Checklist
• Adult Female History Questionaire
• Adult Male History Questionaire
• Child History Questionaire
• Release of Records
• Payment Agreement
• Credit Card Authorization for Recurring Payments
• Medicare Private Contract (only applies to Medicare Patients)
  
  

Acupuncture Forms

• Acupuncture Registration Form & Consent Form
• Acupuncture Questionaire
  
  • Acupuncture Online Questionaire
  • Acupuncture Questionaire (please print or email once completed)
• Brief Medical History
  • Male History
    or
  • Female History

Advanced Directive Forms

• Health Care Proxy
• Living Will
• or Complete these online