Downloadable Forms

The most common forms used in the clinic for new patients can be downloaded by click the links below:

New Patient Information Questionnaire(English)

New Patient Information Questionnaire(Chinese Simplified 中文简体)

New Patient Information Questionnaire(Chinese Traditional 中文繁体)

Acknowledgement of Receipt of Notice of Privacy Practices

Verification of Insurance Coverage for Acupuncture

You may also need:

Notice of Privacy Practices

Protected Health Information Patient Access Form

To open and view these document, you need Adobe Reader. It can be downloaded for FREE from adobe reader to get the latest version of Adobe Reader.