Providing pain relief and Traditional Chinese Medicine

Patient Forms

Before you come in for your initial consultation, please print and fill out the Initial Patient Intake form. This will give you a chance to go over it at home and look up any medical information you may need. If you have any medical records related to your condition, please bring them with you to the initial consultation – this will give us a chance to have more accurate understanding of your condition.


Click on the form you want to download.

General New Patient Form – PDF version

General New Patient Form – WORD version

New Fertility Patient Form – PDF version

New Fertility Patient Form – WORD version