New Patient Forms
Please read this information carefully, and ask your practitioner if there is anything that you do not understand.
Your answers on this form will help your provider understand your medical concerns and conditions better.
Health Information Privacy (HIPAA)
This notice describes our office’s policy for how medical information about you may be used and disclosed, how you can get access to this information, and how your privacy is being protected.
Financial Policy & Fee Schedule
This form describes specific services, fees and important information concerning insurance and payment policies.
Scope of Practice & Qualifications
This form describes the scope of practice for an East Asian Medicine Practitioner (EAMP, formerly designated L.Ac.), as defined by Washington State, and the qualifications of your practitioner.