Intake Forms

Before your first visit to Island Acupuncture, please print and fill out one of the following forms. Then bring it with you to your first appointment.

Acupuncture Intake Form (Pain only) (pdf format)

Acupuncture Intake Form (Complex) (pdf format)

Massage Intake Form (pdf format)

The following document may also help you speak with your insurance company in a way that might lead to coverage. This is for your reference only.

Insurance Information & Checklist (pdf format)