Clinical Brochures & Patient Forms

The links below are our clinic’s patient forms we use to understand your issue(s), and for us to best put together a treatment plan tailored uniquely to your health and wellness goals. You may download, print, and fill out these form before your first initial treatment session.

New Patient: Health Intake Forms

Simple Health Status Form

Detailed Patient Health History Form

Privacy to Patient Information Notice Form

HIPAA Privacy Notice Form

You can fill out the Privacy to Patient Information Notice Form online using the form below:

Patient Treatment Informed Consent Forms

ICH Patient Treatment Informed Consent Form

You can fill out the Informed Consent Form online using the form below:

The following are downloadable brochures that contain information about some of the services we offer:

ICH Introductory Brochure

Acupuncture Brochure