Old Paper Forms

Please do not use these form unless you encounter a problem to access onboard forms from the "mange your appointment" button provided in the appointment confirmation email.

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.