The following forms may be filled out at the office prior to your initial intake, or they can be downloaded here.
- New Patient Form.
- Arbitration Agreement and Informed Consent (Please print in color)
- Also sign the Consent for Use and Disclosure of Health Information, in which you can make clear to whom you will allow disclosure of your protected health information.
Acupuncture Ecology is committed to your privacy.
- Birth History. This form is not absolutely required, but can be very helpful in cases of chronic illness, or conditions that originated in childhood.