AG Acupuncture
Patient Forms
Please download, print, and complete the forms below before your first appointment.
New Patient Intake
Complete health history and reason for visit.
Notice of Privacy Policies
How your personal health information is used and protected.
Cancellation policy and advice to consult physician
cancellation policy and advice to consult your physician.
Arbitration Agreement
Agreement for resolution of any disputes.
Informed Consent to Treat
Authorization and informed consent for acupuncture treatment.
The above documents are available for download in PDF format. Adobe Reader (version 8 or higher) is required to open PDF files and can be downloaded from Adobe.com.