PLEASE NOTE: Before your initial visit, please be sure to print and complete the appropriate form. If you wish to use the fillable form feature, you will need to click on the link and save the form to your computer (do not fill it out online). Once you are done filling out the form, please be sure to either save it or print it to PDF if you wish to save a copy, or just print it out. The form DOES NOT automatically save entered information once you close it. You may also just print out the form and fill it out by hand.

If you wish to email the completed form to our office, please email it to reminder@tianshiacupuncture.com.

If you are coming to our office for issues other than fertility, please fill out the New Patient Intake Form (not needed for female fertility patients):

New Patient Intake Form

If you are female and coming to our office for fertility issues, please fill out the Women's Fertility form below. 

WOMEN'S FERTILITY FORM

If you would like to read our Notice of Privacy Practices, please click on the link below:

Notice of Privacy Practices

You'll need Adobe Acrobat Reader to access the PDF forms on this page. If you don't have it, simply click on the icon below to go the download page and follow the instructions.New Patient Intake FormNew Patient Intake FormNew Patient Intake FormNew Patient Intake FormNew Patient Intake Form