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5555 N. Lamar Blvd., Suite K-104 Austin TX 78751  512.656.3060  ©2014 Medical Arts Acupuncture & Oriental Medicine

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Please download the appropriate forms and fill them out prior to the initial session.

 

If you do not have an access to a printer, we have these forms available at the clinic too.

Female Patient Intake Form

Male Patient Intake Form

Arbitration and Consent From **Requires a COLOR printer

Insurance Coverage Verification Form (optional)

 

 

Note: The Arbitration and Consent form needs to be printed in color per malpractice insurance company’s instructions. We have it available at the clinic if you do not have an access to a color printer. The rest of the forms can be printed in black and white.

 

 

New Form for Nutrition Analysis

Systems Survey Form

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