If you want to you can decrease the time spent at the waiting room, you are alway welcome to complete these forms from home. Print and sign the consent form above, and the acupuncture 5 elements intake form below, and then fill out the Google Form below, click submit. You can also wait and fill out at the office if you need help with it.

Five elements questionnaire for new acupuncture clients only:

Download and print forms above, or fill out the online forms below

Fill out the comprehensive questionnaire, and the five elements questionnaire, before your first appointment, click the submit button at the end of each.

Your wellness, customized by experts.

  • Whether you have a chronic condition or you’re just looking to be your best self, we customize your formula to you
  • Fill out forms
  • Chat with a licensed Eastern medicine expert, without leaving the house, to find your formula
  • $175 one time fee, plus cost of herbs

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