We have online forms for you to complete in the convenience of your own home or office.

• If you do not already have AdobeReader® installed on your computer, Click Here to download.
• Download the necessary form(s), print them out and fill in the required information.
• Fax us your printed and completed form(s) or bring it with you to your appointment.

New Patient Health History Forms - Required

Our forms give us your history and current state of health. Let us know if you have any questions, concerns, or goals regarding wellness. We can help you.

Chiropractic Health History Form

Download & Print Form

Acupuncture Health History Form

Download & Print Form

ACN Group Form - Required with Cigna and United Healthcare Plans

Acupuncture Informed Consent Form - Required for all Acupuncture/Chinese Medicine Treatments

Member Wellness Registration Form - Optional

This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our office. You can print it out and bring it in to our fax it to us at (925) 736-3215. The online newsletter sign-up is also on the right of our Home Page. We look forward to making your experience with our office and website more interactive and rewarding.