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New Patient

Online Forms

page 4

There are 5 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 fourth form is a

Patient health self-evaluation.  


It is very thorough and detailed evaluation

of the patients 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.