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New Patient Forms

New patients, please download and Complete the appropriate forms prior to your first appointment.

*Clinic Guidelines for Covid-19 and Patient Safety Consent

Informed Consent/New Patient Health History

Covid-19 Response Plan (Read Only-does not need to be printed out.)

HIPAA Notice of Privacy Practices (does not need to be printed out)

Insurance Form (only fill out if you have acupuncture coverage)All services are self-pay. A superbill can be provided for reimbursement.

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586.221.0650 Directions Contact/Schedule