Acupuncture Client Forms

You may download and fill out the forms listed below before arriving at your first acupuncture appointment. Please click on the name of each form to access the printable PDF of each form.

Health History Form

Acupuncture Client Information Form

Before and After Instructions

Please Note: Blue Cross Blue Shield Clients

If you are a Blue Cross Blue Shield client, please complete the Acupuncture Insurance Verification and Statement of Financial Responsibility forms below before arriving at your first acupuncture appointment and bring your insurance card with you. Click on the links to access the printable PDF of each form.

Acupuncture Insurance Verification Form

Statement of Financial Responsibility