New Patient Forms
In-Person Appointment Forms:
Telemedicine Appointment Forms:
Only fill this out if you are scheduled for a telemedicine appointment:
What to Bring to Your Appointment:
- A water bottle.
- List of medications and supplements you are taking.
- Please arrive having had something light to eat before the appointment. Receiving acupuncture on an empty stomach may result in you feeling dizzy or lightheaded. Your comfort and wellbeing are important for you to gain the most benefit from your session. If circumstances require that you arrive hungry, please let us know and I will be happy to give you a small snack before your treatment.
COVID-19 Procedures:
The following procedures are universal for all practitioners seeing patients at our location. This ensures safety for you and all of our patients. Please read carefully as these procedures affect what you should expect when you arrive for your appointment:
- If you are scheduled for an upcoming appointment, I ask you to self-screen yourself prior to coming in, assessing whether or not you have the following symptoms: cough, shortness of breath, tiredness, fever, chills, headache, temperature, sore throat, loss of taste or sense of smell, muscle pain, chest pain, nausea, vomiting and or diarrhea. If you have any of these symptoms I ask that you do not come in for acupuncture treatment. Instead I can offer you support through herbal therapies and possibly other lifestyle, dietary recommendations. Please call your doctor first if you have any of the above symptoms, and feel free to call me too if some of your symptoms such as nausea or diarrhea seem as though they may not be related to Covid-19.
- I am asking that everyone scheduled for an appointment please check their temperature before coming in if you are able to. I will check your temperature again upon arrival.
- I am requiring everyone who comes into the clinic to please wear a mask, and to clean your hands with hand sanitizer before entering the building (I will bring a bottle of hand sanitizer for you to use when I greet you at the front door).
- I will also be wearing a mask and will be using hand sanitizer and washing my hands frequently.
Office Location:
Click address to open in Google Maps.
6527 21st Ave NE Seattle, WA 98115
Parking:
The office is located on ground level of a yellow residential building. The building is the last building on the left side of the street, across from the tennis courts. Please call (720) 515-0130 when you arrive so that I can greet you at the front door.
