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Intake Form

Please fill out and bring in a printout.  


Medical History

Please bring copies of all previous blood work or diagnosis to the initial visit.   Also bring any prescriptions that you are taking.


If you are taking supplements such as herbal teas, vitamins, or are using essential oils bring these along with you.


Fees & Payment Options

Please bring your insurance information with you.

Payment due at time of appointment.

  • First Visit - Comprehensive One hour, 15 mins.

  • Follow Up Visit - Price Based on Time

  • Acupuncture - New includes consult

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