New Patient Paperwork

Welcome to The Acupuncture Clinic.  Thank you for trusting us to your care.   We are looking forward to seeing you.  Please give yourself some time to look over the new patient paperwork and complete before you come in for your first treatment.   We will spend time reviewing this together at your appointment.  The first treatment takes more time so plan for a 2-hour visit. 

Please download the new patient forms and bring them to your first treatment with Jayne.   

Determine Benefits Form (pdf)

Download

HIPPA consent form new patient (pdf)

Download

NAET Consent Form - Acupuncture Clinic - Master (pdf)

Download

Medical Symptoms History (pdf)

Download

Patient Intake Form (pdf)

Download