New Patient Forms
Consent to Disclose Form
Please read this information carefully, and ask your practitioner if there is anything that you do not understand.
Health History
Your answers on this form will help your provider understand your medical concerns and conditions better.
Download PDF Health History Form
Email Consent
Financial Policy & Fee Schedule
This form describes specific services, fees and important information concerning insurance and payment policies.
Download PDF Financial Policy Form
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.