Acupuncture & Integrative Medicine Specialists Located in Portland, Oregon

Forms & Patient Info

New Patients: Please complete the new patient forms below and bring them with you to your first appointment. If you are not able to get them finished ahead of time please plan to arrive 30 minutes early. We know the forms are lengthy but it allows us to get the information we need to treat you holistically yet still focus on your current concerns at your initial appointment.

If you do not have printer access: please feel free to give us a call and we can mail you the forms prior to your visit.

Additionally, for naturopathic appointments, please bring copies of any labs you have had done in the last 3 years.

Questions about fees or insurance

What to expect at your first appointment

To make an appointment please call our office at 503-977-0500

All new patients should print and fill out a full set of forms, either adult or pediatric.

Choose from the following initial new patient paperwork:

Note: If you’re not certain whether you will be doing both acupuncture and naturopathic, begin with the naturopathic paperwork, and the acupuncture paperwork can be added at a later time, after you have had your first appointment.

1. Naturopathic

Age 13-Adult

Pediatric

2. Acupuncture

Age 13-Adult

Pediatric

3. Naturopathic and Acupuncture

Age 13-Adult

Pediatric

Please note, you will have an opportunity to ask any questions you have about the content of the Consent to Treat at your visit.

The forms are in PDF format. Download Adobe Acrobat Reader if you are having trouble viewing the forms.

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This website is for informational purposes only, and is not a substitute for individualized medical or professional advice, care, diagnosis, or treatment. Consult your personal physician regarding the applicability of any information on this site.