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Integrating Eastern &Western Medicine

for Your Healing Journey

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New Patient Forms & Information

(for new patients only; please call for password)

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Initial Patient Packet all 14 pages

Initial Patient Letter and Consents Only (7 pages)

Initial Patient Clinical Only (7 pages)

Letter to New Patients--IMPORTANT to read before your first visit

Policies and Procedures, Clinical

Policies and Procedures, HMO and Labs

Request and Consent for Holistic Medicine Evaluation and Treatment

HIPPA Notice (Required by Federal Government, (2 pages)

HIPPA Receipt

Initial Patient Form Page 1 (Demographics & Contacts)