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Online Forms

Acupuncture Healing & Wellness, LLC offers our patient form(s) online so they can be completed it in the convenience of your own home or office.

  • If you do not already have AdobeReader� installed on your computer, Click Here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.


New Patient Health History Form - Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding acupuncture can we help you with? Let us know!

Download & Print Form (pg.1)
Download & Print Form (pg. 2)
Download & Print Form (pg. 3) 


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