The following forms are formatted for Adobe Reader (PDF). Simply download the file and print them out. Please fill out the forms to the best of your ability and bring them with you to your first visit.

Health History Questionnaire
for your first Acupuncture visit
Stop Smoking Special)


If quitting smoking please read -

If you have any difficulty downloading or printing these documents, you can always fill them out at the office. Just plan on arriving 20 minutes before your first visit.
*try printing double-sided to save paper!