New Patient Forms

Please print out, read and complete all of the following forms and bring them to our office when you come for your appointment.

Registration Form

Health History Form

HIPAA Privacy Form - Read this form. Do not bring a copy to the office.

Notice of Privacy Practices

Informed Consent Form

Assignment of Benefits Form

Financial Agreement

 
newpaltz-acupuncture-model-chinese-medicine.jpeg

For appointments or information:

You may use this form to contact us. You may ask questions, or request an appointment. You may also call or text us at any time