• Home
  • About Us
    • Emily Liburdi, Dipl. O.M, MSTOM, R. Ac.
    • Testimonials
  • Treatments & Fees
  • Acupuncture Info
    • Conditions Acupuncture Can Help
    • FAQs
    • What Is Acupuncture?
    • Modern Research & Acupuncture
    • First Visit
  • Community Acupuncture In Michigan
  • New Patients
    • New Patient Info
    • New Patient Forms
  • Contact Us
    • Contact Form
    • Map & Directions
  • Support Local Community

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)

cranes for new patient forms

New Patient Forms was last modified: November 3rd, 2020 by admin

  • Click here or call to request an appointment
  • Clinic Logo
    Michigan TCM Wellness Center
    45163 Cass Avenue
    Utica, Michigan 48317

    586.221.0650

  • Mon & Thurs 10am - 6pm

  • Follow Us!

    Follow Us on FacebookFollow Us on LinkedInFollow Us on Google+
  • Read all... »

    Testimonials

    “I have been seeing Emily for several years. Her acupuncture treatments have helped my sinus issues and overall relaxation. She is very knowledgeable, kind and accommodating. I highly recommend her to everyone.”-G.S.

    Sinus Issues was last modified: May 10th, 2020 by Emily Liburdi

    “Emily is very professional and knowledgeable in the field of acupuncture. I cannot thank her enough for the relief of pain she has given me.”-D.M.

    Knee Pain was last modified: May 10th, 2020 by Emily Liburdi

    “I’ve had a few treatments with Emily and had physical issues corrected. She is extremely knowledgeable in, not just acupuncture, but also the physical body and traditional plant medicine that goes hand in hand with your treatments. TCM and Emily have a very welcoming and loving energy and I highly... Read more »

    “My husband and I have been going to Michigan TCM Wellness Center for over a year now. It has become a great way for us to do a little self-care, and take time out of our busy day to relax and ensure continued wellness. My husband has been going for

    ... Read more »

    “I have been seeing Emily for back pain due to degenerating discs for about a year now. The pain has been helped substantially. Emily is very knowledgeable in her techniques and her office is relaxing and clean! Highly recommend her!” -K.M.

    Back Pain was last modified: May 10th,

    ... Read more »
  • Acupuncture in Downtown Utica, MI

Michigan TCM Wellness Center specialties in: Acupuncture, Traditional Chinese Medicine, Herbal Medicine, Cupping, Massage, Wellness, Health, Fertility, Dry Needling, Orthopedic Needling, Electro-Acupuncture, Estim

Michigan TCM Wellness Center treats the following conditions: indigestion, reflux, nausea, gastritis, irritable bowel syndrome, constipation, diarrhea, colitis toothaches, laryngitis, canker sores, ringing in the ears, sore throat, TMJ sinusitis, bronchitis, asthma, emphysema, skin rashes, allergies, leg swelling, cold extremities, urinary incontinence, PMS, infertility, symptoms of menopause, irregular periods, painful periods, heavy bleeding, endometriosis, fibroids, neck pain, back pain, knee pain, sciatica, frozen shoulder, bursitis and tendonitis, arthritis, sprains, fibromyalgia and chronic fatigue syndrome, tennis elbow; can also aid with rehabilitation for healing fractures, joint injuries and chronic pain, headaches, carpal tunnel syndrome, trigeminal neuralgia, vertigo, pain from shingles, peripheral neuropathy, stress and tension, anxiety, depression, insomnia post op healing, chemotherapy and radiation therapy, AutoImmune, MS, Hashimoto’s disease, thyroid issues, celiac disease, rheumatoid arthritis, Lupus, infertility, natural fertility care, support to IUI/IVF, chronic miscarriage, impotence, low sperm count, low motility, substance abuse and addiction, smoking cessation, alcohol & drug addiction

Michigan TCM Wellness Center serves the Metro Detroit area including the following cities: Utica MI, Sterling Hts MI, Troy MI, Rochester MI, Rochester Hills MI, Macomb Twp MI, Grosse Pointe MI, Saint Clair Shores MI, Madison Heights MI, Roseville MI, Warren MI, Royal Oak MI, Ferndale MI, Detroit MI, Harrison Township MI, Birmingham MI, Berkley MI, Hamtramck MI, Shelby Township MI, Grosse Pointe Park MI, Fraser MI, Dearborn MI, Detroit MI, Bloomfield Hills MI, Shelby Twp MI, Washington Twp MI, Mt Clemens MI

Acupuncture Websites designed by AcuPerfect Websites © 2021. All Rights Reserved. Terms of Use. Webmail Log in