Patient Forms

Patient Information

Appointments
Please be courteous and call the office with at least 24 hours’ notice if you are unable to attend an appointment. This time will be reallocated to someone who may be waiting for an appointment. Failure to call in advance to cancel the appointment or if you fail to show up for the appointment a $50.00 fee may be applied.


Patient Information Forms
Please bring the completed form’s with you to your scheduled appointment, in order to expedite the registration process. Thank you.

Forms

English Spanish
2016 HIPPA Notice 2016 HIPPA Spanish
Medical History Medical History – Spanish
New Patient Demo New Patient Demo – Spanish
New Spa Client Demo New Spa Client Demo – Spanish
Wellness Patient Client Demo Wellness Patient Client Demo – Spanish
Diet Policy Consent Form Diet Policy Consent Form – Spanish
Acupunture Info Consent Form Acupunture Info Consent Form – Spanish
Medical Records Request Form

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