Clinic Forms

New Patients: Print and fill out this form to speed up the intake process during your first visit.

New Patient Health History Form (PDF, Adobe Reader required)



In addition to filling out the above form and bringing it to your first visit, here are some recommendations.  They will enhance the benefits of your treatments.


Before & after your acupuncture treatments:

1.     Do not wear make-up, perfume or cologne, or heavily scented lotions, shampoos or

soaps to your treatment.  This is particularly important for your first few sessions.

2.     Avoid drinking alcohol for 24 hours before & after your treatments.

3.     It is best to be a non-smoker.  However, if you do smoke, please refrain for several

        hours prior to your treatments. 

4.     Recreational drugs of any kind have an adverse effect on your treatments.

5.     Eat before your treatment.  However, it is best to avoid having an unusually large meal

before or immediately after your treatment.

6.     Avoid very hot or cold baths or showers the day of your treatment.

7.     Do not rush to your appointment.  It is better to be a few minutes late than to

arrive with an elevated pulse or blood pressure.  I want your session to be relaxing,

not stressful.

8.     Continue taking all prescription medications and treatments, exactly as directed by

your physician or other healthcare providers.

9.     Plan your activities so that after your treatment (especially at first), you can get

some rest and allow your body to gain the maximum benefit from your treatment.

10.  Note and report any changes in physical or emotional symptoms and patterns that

may occur between your acupuncture treatments.  These details are valuable in

planning future treatments.


Please print this sheet and refer to it in the future.  Thank you!