Appointments

Take your first steps to improving your health and well being.

Step One
Call (503) 885-7600 to set up your initial appointment. Se Habla EspaÑol.

Step Two
Print and fill out corresponding forms and bring them to your first appointment.

FORM NAME: Patient Registration Form
Acupuncture Patients
Description: Patient contact info, auto/heath insurance info, referring provider.
Download Patient Registration Form
FORM NAME: Patient Consent Form
ALL NEW PATIENTS
Description: Consent to be treated.
Download Patient Consent Form
FORM NAME: Financial Agreement
Pertains: ALL NEW PATIENTS
Description: Financial Agreement outlining financial responsibilities
Download Financial Agreement
FORM NAME: Privacy Policies
Pertains: ALL PATIENTS
Description: HIPAA Information and an explanation of how we ensure your privacy.
Download Privacy Policies
FORM NAME: Privacy Acknowledgement
Pertains: Acupuncture Patients
Description: Acknowledgement of receipt of privacy policy statement.
Download Privacy Acknowledgement

FORM NAME: Medical Records Release Authorization
Pertains: All auto accident claimants
Description: Patient authorization for the release of medical information to third parties
Download Medical Records Release Authorization

Step Three
Make a list of health concerns and personal goals. What do you want to address with your provider?