Become a New Patient

We are currently accepting new patients into our practice. Thank you for considering us. To become a new patient:

When you come to our office for the first time as a new patient, we'll ask you to complete some initial forms, including an Authorization and Consent for Treatment form, if you were not able to download them from the patient portal in advance of your appointment.

To make sure there are no delays in care during your first visit experience, please arrive 15 minutes prior to your scheduled appointment to ensure your registration is complete before meeting with your new provider.

Remember to bring:

Your insurance card
Valid photo ID
List of current medications
Office co-pay

In an effort to respect the time of all of patients, our staff strives to stay on schedule so that other patients do not have to wait.

For patients who are delayed and arrive late for appointment, every effort will be made to see them the same day. However, wait times may apply, or appointments may need to be rescheduled.

Proactive Forms

Patient History Forms

If you were unable to complete the electronic forms sent to you via our third party patient forms platform JaneApp, please download the forms that apply to your appointment type. This lets us know the history and current state of your health. What questions, concerns, or goals regarding wellness can we help you with? Let us know!

New Patient Paperwork (First-Time Patients)

New Acupuncture Patients

Re-Evaluation Form (6+ Months Since Last Visit)

Functional Forms

Some insurance providers require additional forms for coverage. To help your insurance and your provider better understand your condition and track your progress, please fill out the form related to your condition.

Neck Index Form

Back Index Form

Lower Extremity Functional Scale (LEFS)

Arm, Shoulder, or Hand Form (DASH)

Low Back Disability Questionnaire (Oswestry)

Patient Forms

Authorization for Release of Medical Information (PDF) - Allows patients to authorize the disclosure of their health information to a designated individual, company, agency, or facility. Autorización De HIPAA Para Divulgar Información Del Paciente

Authorization and Consent for Treatment (PDF) - All patients must provide their consent for treatment, communications (calls, emails, and text messaging), and agreement of financial responsibility. Autorización y Consentimiento Para el Tratamiento

Preferred Contacts (PDF) - Patients are encouraged to complete and return the Preferred Contacts Form but it is not required. Contactos Preferidos

Virtual Visit Policy (PDF) - This policy describes the process for the documentation, maintenance, and transmission of information using virtual visit technology.

Office Policies

Financial Policy (PDF) - This form advises patients of their complete financial responsibility for all medical services received without regard to insurance eligibility or coverage determinations. Política Financiera (PDF)

Notice of Privacy Practices (PDF) - Describes how health information about you (as a patient of this Care Center) may be used and disclosed, and how you can get access to your individually identifiable health information. Please review this notice carefully. Aviso de prácticas de privacidad (PDF)

HIPAA Privacy Notice