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Pure Acupuncture & Natural Medicine offers our patient form(s) online so they can be completed it in the convenience of your own home or office.

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

New Patient Forms - Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding acupuncture can we help you with? Let us know!

 Click Here for Our New Patient Forms.

 Click Here for Our New Patient Welcome Letter

 Click Here for Our General Consent Form.

 Click Here for Our Metabolic Assessment Form.

 Click Here for Our Medical Release Authorization Form.


Weight Loss Questionnaire

Download & Print Form

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