Welcome to Merriam Park Acupuncture!
We are honored and delighted that you have chosen us as your acupuncturist practice. We look forward to partnering with you to address your health concerns and we will do all we can to ensure you achieve the most successful result possible for you.
- For the sake of social distancing, please complete these forms at home. You can type the information into the pdf and then print, or print the blank pdf and hand write your information.
- If you do not have an option to print, please send us an email letting us know you will arrive 15 minutes before your appointment to fill out the forms.
We will go over your intake form in depth during your initial appointment. Prepare to have your first appointment be around an hour to an hour and a half. Your treatments will be centered around your health as a whole and not just one symptom. No complaint is too small.
If you are using insurance please email us the name of your insurance carrier, ID number, group number, and your date of birth.
We ask that you contact us 24 hours prior to canceling your appointment. We have a $50 late cancelation or no-show fee. You will not be charged if the reason is due to an emergency, illness, or inclement weather.