Get the free SouthtownsAcupunctureIntakeForm2018

./Touchdowns, ... YO.'r'.ACUPUNCTURE AND HERBS ....:::,,,Sarah Nelson First, L. Ac. Kevin First, L. Ac. Board Certified & Licensed AcuJJuncturisL7166494015www.southtownsacupuncturc.commonly's date

How to fill out southtownsacupunctureintakeform2018

How to fill out southeastacu.com/services-2/new-patient-intake-form/

1. Start by downloading the southtownsacupunctureintakeform2018 from the Southeast Acupuncture website.
2. Print out the form or open it in a PDF viewer on your computer.
3. Begin by entering your personal information, including your full name, address, phone number, and email address.
4. Next, provide your date of birth, gender, and occupation.
5. Indicate your marital status and emergency contact information.
6. The form will ask for your primary reason for seeking acupuncture treatment. Provide as much detail as possible to help the acupuncturist understand your specific needs.
7. In the medical history section, provide information about any current or past medical conditions, surgeries, or injuries. Be sure to include any recent or ongoing treatments or medications.
8. Specify any allergies or sensitivities you may have, including medications, food, or environmental factors.
9. Provide information about your current medications, including the name, dosage, and frequency of use.
10. In the lifestyle section, provide information about your sleep patterns, exercise habits, and stress levels.
11. If applicable, indicate any specific dietary or nutritional concerns or restrictions.
12. Sign and date the intake form to acknowledge that the information provided is accurate and complete.
13. Return the completed form to the Southeast Acupuncture clinic either by mail, email, fax, or in person.

Who needs southtownsacupunctureintakeform2018?

1. Individuals who have never been to Southtowns Acupuncture before and are seeking acupuncture treatment.
2. Patients who have visited Southtowns Acupuncture in the past, but their last visit was more than a year ago.
3. Anyone who has experienced changes in their health or medical history since their last visit to Southtowns Acupuncture.
4. Individuals who are seeking a holistic approach to their healthcare and want to explore the benefits of acupuncture.
5. Patients who have been referred to Southtowns Acupuncture by another healthcare provider.
6. Individuals who are curious about acupuncture and want to learn more about the services offered by Southtowns Acupuncture.

Overall, southtownsacupunctureintakeform2018 is suitable for anyone who is seeking acupuncture treatment or interested in exploring the services provided by Southtowns Acupuncture.

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What is southtownsacupunctureintakeform2018?

southtownsacupunctureintakeform2018 is a form used for intake purposes at Southtowns Acupuncture clinic.

Who is required to file southtownsacupunctureintakeform2018?

All new patients at Southtowns Acupuncture clinic are required to fill out the southtownsacupunctureintakeform2018.

How to fill out southtownsacupunctureintakeform2018?

Patients can fill out the southtownsacupunctureintakeform2018 by providing personal and medical information requested on the form.

What is the purpose of southtownsacupunctureintakeform2018?

The purpose of southtownsacupunctureintakeform2018 is to gather relevant information about the patient's health history and concerns to assist the acupuncturist in providing appropriate treatment.

What information must be reported on southtownsacupunctureintakeform2018?

Information such as medical history, current medications, allergies, and specific health concerns must be reported on the southtownsacupunctureintakeform2018.