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Patient Forms

Our Atlanta Acupuncture Clinic is located in Atlanta Georgia

Below are links to forms that you can download, print, and fill out. You can then either fax or mail the forms to the clinic to provide information for an appointment.

The forms listed below are set up as PDF  files. To view and print these files, you will need the FREE Acrobat Reader browser extension or application from Adobe. See below for a link to download Acrobat if your browser does not already include this extension.


Please note: clicking on the links below will open a new window to load the form and/or launch the Adobe Acrobat Reader application. This window will remain open behind the new one. If a new window does not open, and you are asked to save the file, then you do not have the Adobe Acrobat Reader plug-in installed for your browser. Installing the plug-in (see below) will allow you to view and print all PDF files directly from your browser window.


If you have any trouble downloading and printing our forms, they are also available at our office. You may either pick them up, or contact us by phone or email if you would like them mailed to you, or fill them out at our office before your first visit.


phone: (404) 233-5080
fax: (404) 233-1327
Download Forms:
 If you are coming in for Fertility please also fill this out: