New Patient
Paperwork

Please complete the intake form before your first visit. The form is fillable: you can complete it on your computer or phone, or print it and fill it in by hand. Bring the completed form with you to your first visit. If you prefer paper at the clinic, please arrive a few minutes early.

New Patient Intake Form (PDF)

Download the intake form (PDF)

Your practitioner is Rupali Jain, L.Ac., Dipl. O.M. (NCCAOM).