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New Patient
Online Forms
page 5
Patient Self-Evaluation

There are 2 more forms in our new patient paperwork.  
Thank you for taking the time to complete these forms.
 
If you would like copies of any of these two forms,
please let us know at the time of your visit.

This 5th form is a
Patient health self-evaluation.  
 
It is very thorough and detailed evaluation
of the patient's current and past health.  
While it is important and useful to fully diagnose the patient,
it is not necessary to complete in order
to receive treatments at the iowa acupuncture clinic.