Forms

 
 
For all new patients

 

       New patient intake form

 

       Patient consent form

 

       HIPPA privacy policy form

 

       Contact information form

 

For GYN/Infertility patients

 

        BBT Chart

 

For facial rejuvenation patients

 

        Informed consent for facial acupuncture [available later]

 

For Independent Medical Evaluation (IME) Patients
 
        IME form   
 
Other Forms
 

        Medical release form

 

        Cooking instruction for raw herbs

 

        How to take powdered herbs

 

        Food journal

 

If you are unable to download forms, please

      

        Download Adobe Acrobat reader

 

 

 

 

    

Website by Lei-Lei C. Wang. Copyright © 2009 Acupuncture and Herbal Medicine Healthcare. All Rights Reserved.