Online Forms

153 Acupuncture & Herbs Healing Center offers our patient form(s) online so that they can be completed in the convenience of your own home or office.

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

NEW PATIENT HEALTH HISTORY FORM - REQUIRED

This allows us to know your past medical history as well as your current health state. Do you have any concerns or questions regarding acupuncture? Please let us know on this form as we would like to help you!

Download & Print Form


NEW PATIENT QUESTIONNAIRE FORM - REQUIRED

Download & Print Form



Download the Free AdobeReader®

Office Hours

Our Regular Schedule

Monday:

Closed

Tuesday:

9:30 am-6:00 pm

Wednesday:

9:30 am-6:00 pm

Thursday:

9:30 am-6:00 pm

Friday:

9:30 am-6:00 pm

Saturday:

9:30 am-2:30 pm

Sunday:

Closed

Locations

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