Intake Forms

• Please download all forms listed below by clicking on the PDF icon
• Fill out completely and sign
• Bring to appointment
• Our office manager is hearing impaired. To assist her in her goal to help enhance your healing experience at the Eugene Center for Acupuncture, it will help if you can face her when speaking to her and to try to speak slowly and clearly.

Health History Questionnaire
HIPAA Privacy Policy
HIPAA Notice
Informed Consent Form
Cancellation Policy