​Acupuncture Forms

Acupuncture :Online Initial Intake Form

MANDATORY DISCLOSURE

Online Hippa Form

Fertility Patients Only Intake

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The online insurance form is for Patients that are in network with Blue Cross/ United Healthcare for Acupuncture. 

Online Insurance Consent Form

The form below is for Auto Accidents/ Personal Injury Claims only. 

Personal Injury / Auto Injury Liability Form

To fill out the form, please click each link, and submit, we will receive the form via Email. 
Thank you!
Please fill out the first three forms, if you are an Insurance Client, please fill out the insurance waiver as well. 
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Massage Therapy Forms

Massage Therapy Intake