New Patients

Please print out and complete the following forms. Please bring them to you first appointment so that you can get the most out of your treatment.

 

 

Health History:

 

 

Privacy Practices:

 

 

Receipt of Privacy Practices:

 

 

Informed Consent:

Fee Schedule/Office Policies: 

Please prepare for your appointment by:

  • Make sure to eat something light an hour or two before arriving

  • Wear loose fitting clothes

  • Bring a list of medications you are taking

© 2017 by Mossop Acupuncture

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