Please download, print, fill out, sign and date these forms with the date of your appointment with the doctor. You will need to have these forms with you at your scheduled appointment date and time, otherwise your appointment may be cancelled or rescheduled. At your request, you may contact the office to have the forms emailed directly to you as an attachment.
If you are an ACUPUNCTURE PATIENT download, print, & fill out these forms:
- Consent for Acupoint Injection/Biopuncture Therapy
- Informed Consent to Treat
- Payment for Services Agreement
- Patient Office Policies
- Patient Inform/Medical History
- Patient Inform/Medical History (Spanish)
If you are a PODIATRY PATIENT download, print & fill out this form:
- Patient Inform/Medical History (Podiatry)
Forms to download, print, & fill out for BOTH:
- Notice of Privacy Practices NO SIGNATURES REQUIRED. READ ONLY.
- Privacy Practices Acknowledgement
- Patient Health Information Consent Form
If you are a GROUPON PATIENT download, print, & fill out these forms:
In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.