Patient Forms & Guidelines

We want to get to know you better. New patients must complete a few short forms, and we encourage you to print and fill them out ahead of time. It’s also helpful to come in ready to ask any questions so that you’ll leave our clinic armed with the knowledge you’ll need to make informed decisions.

Office Policies

This outlines our office and financial policies and ways you can pay. Our insurance experts and administrative team will walk you through it during your visit to help you better understand all the details.

Informed Consent

This is an official notice of your rights as a patient and our responsibilities to maintain your privacy. We just need your signature acknowledging we have given you a copy of this document.

Adult Initial Health History

We ask you about your symptoms and lifestyle so we can better understand your specific condition, concerns and goals. We also ask about your general health, medications and allergies.

Pediatric Initial Health History

We ask you about your symptoms and lifestyle so we can better understand your specific condition, concerns and goals. We also ask about your general health, medications and allergies.

Contact

Address: Westchester Acupuncture
111 N. Central Park Ave.
Suite 270
Hartsdale, NY 10530

Phone: (917) 273-8912

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