Medical Evaluation forms ensure we capture your health issues and concerns so that we can appropriately discuss options to assist you to reach your optimal health.  Additionally they allow us to monitor and demonstrate your progresss.Prior to your appointment, we ask that you answer some questions about yourself. The questionnaires are below for your convenience.  Click the links to download the appropriate form, print it out, complete it and bring it with you to your initial consultation.

Prior to your appointment, we ask that you answer some questions about yourself. The questionnaires are below for your convenience.  Click the links to download the appropriate form, print it out, complete it and bring it with you to your initial consultation.

Medical Evaluation Patient Intake Form Holistic Homeopathic Acupuncture Massage Herbal Traditional Chinese Natural Medicine Center Lakeland Central Florida

Acupuncture Patient Evaluation Forms

For Alexandra Clinton Acupunture Treatment Evaluation Form