Clinic Forms

Clinic Forms 2017-05-31T15:14:56+00:00

These forms are for new patients in our acupuncture or Chinese herbal clinics.

Patient Information Form
Download the Patient Information Form
Informed Consent
Download the Patient Consent Form

You may:

  1. Print forms, complete by hand, and bring to your first appointment.
  2. Download forms, open in Adobe Reader, and type in information. Then the forms can be emailed directly to your practitioner or printed, signed and brought with you. Adobe Reader is free of charge. If you do not have Adobe Reader, you can download it here.

Please contact us by phone at 352.548.2332 if you have any questions or difficulties.