Forms

Print and complete these forms to bring to your first appointment.

Acupuncture – Intake Form

Click on the image below to download and print our Acupuncture Intake Form.

Acupuncture – Auto Accident Questionnaire

Click on the image below to complete the Auto Accident Questionnaire form and bring to your first appointment if applicable.

Massage – Fees and Office Policies Agreement

Click on the image below to print and complete the Massage Fees and Office Policies Agreement.

Massage – Prescription

For most insurance claims, you will need to provide a prescription.  Please print and present this to your primary care provider or chiropractic physician for them to fill out or they may use their own prescription form.  Then bring the form to your appointment or have your doctor fax a prescription to us at (206) 452-5965.

Massage – Health Intake Form

Click on the image below to print and complete the Massage Health Intake Form.

Massage – Insurance Form

Click on the image below to print and complete the Massage Insurance Intake form.  We will require a copy of your driver’s license and health insurance card at your first appointment.