Acupuncture, moxibustion, Chinese herbs

New Patient Intake Forms

*All New Patients

Please print and fill out the following “New Patient Intake Form” below, and bring in to your first scheduled appointment.

*Fertility Patients

Please ALSO print and fill out the “Fertility Intake Form” and bring it with you. This form is for patients who have undergone testing, diagnostic or treatment procedures, including IVF/IUI.  You may need to first download and then install the Free Adobe® Reader® software in order to use these form downloads.

New Patient Form


New Fertility Patient Form