Please down­load and com­plete the fol­low­ing forms and bring them with you to your first appoint­ment.

Consent to Treat Form:


Medical History Intake Form:


Symptom History Intake Form:


An indi­vid­ual is con­ceived whole, bro­ken apart by the world, and recon­sti­tut­ed through acupunc­ture.

The prac­tice of acupunc­ture as a pal­pa­tion-based med­i­cine brings the acupunc­ture prac­ti­tion­er into direct phys­i­cal con­tact with an individual’s imbal­ances, be they any com­bi­na­tion of men­tal, phys­i­cal, emo­tion­al, or spir­i­tu­al aspects of a per­son.

Every phe­nom­e­non that occurs in the body is observ­able through pal­pa­tion, and pal­pa­tion pro­vides a direct feed­back mech­a­nism to eval­u­ate the effec­tive­ness of an acupunc­ture treat­ment.