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3885 Duke of York Blvd., Suite C211, Mississauga, ON L5B0E4 T: (905)2766800 F: (905)2766802 www.NaturaWellnessClinic.com DATE OF FIRST VISIT: ACUPUNCTURE NEW PATIENT INFORMATION FORM NAME: D.O.B.
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How to fill out acupuncture - new patient:

01
Begin by entering your personal information, including your full name, date of birth, and contact information. This will help the acupuncture practitioner to have your details on record for further communication and identification purposes.
02
Next, provide information about your medical history. This may include any current or past medical conditions, medications you are taking, surgeries or procedures you have undergone, as well as any allergies or sensitivities you may have.
03
It is important to mention your reason for seeking acupuncture treatment. Explain your symptoms or the specific condition you are looking to address. This will assist the acupuncturist in creating an appropriate treatment plan tailored to your needs.
04
If you have any previous experience with acupuncture or other traditional Chinese medicine treatments, specify the details. This will give the practitioner insights into your familiarity with the practice and what has worked or not worked for you in the past.
05
Before your first acupuncture session, you may be required to sign a consent form. Read it carefully and provide your signature if you agree to the terms and conditions outlined.
06
Finally, if you have any questions or concerns regarding the acupuncture treatment or the filling out of the new patient form, do not hesitate to ask the staff or your acupuncturist for clarification. They are there to assist and ensure your comfort throughout the process.

Who needs acupuncture - new patient:

01
Individuals experiencing chronic pain: Acupuncture is commonly sought after by individuals dealing with chronic pain conditions such as back pain, joint pain, migraines, or arthritis. It can provide relief and help manage pain without relying solely on medication.
02
Those seeking stress relief and relaxation: Acupuncture is known to promote relaxation and reduce stress levels. It can help balance the body's energy flow, promoting overall well-being.
03
People with various health conditions: Acupuncture has been used as a complementary treatment for a wide range of health conditions, including digestive disorders, respiratory issues, hormonal imbalances, anxiety, depression, and insomnia.
04
Individuals seeking overall wellness: Acupuncture is not limited to only addressing specific health conditions. Many people choose acupuncture as a proactive measure to enhance their overall wellness and maintain a healthy balance in their bodies.
05
Those looking for alternative or complementary medicine: Acupuncture is a part of traditional Chinese medicine and is often sought by individuals who prefer natural, holistic approaches to healthcare or want to supplement their existing medical treatments with alternative therapies.
Overall, acupuncture - new patient forms help acupuncturists gather essential information about your health and medical history to provide personalized and effective treatment. It can benefit a wide range of individuals seeking pain relief, stress reduction, treatment for specific health conditions, or improved overall wellness.
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Acupuncture for new patient involves the insertion of thin needles into specific points on the body to promote healing and relieve pain.
New patients seeking acupuncture treatment are required to fill out the necessary paperwork for their initial appointment.
Patients can fill out the acupuncture intake form provided by the clinic or practitioner, which includes personal information, medical history, and reason for seeking treatment.
The purpose of acupuncture for new patients is to address specific health concerns, promote overall well-being, and provide pain relief.
Information such as personal details, medical history, current symptoms, and any previous acupuncture treatments must be reported on the new patient form.
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