New Patient Form
Complete Our New Patient Form
At Inner Gate Health and Wellness it is our goal to help each patient improve their quality of life and to achieve optimum health. Traditional Chinese medicine, which consists primarily of Acupuncture and Chinese Herbs, offers a unique approach to healing that nicely compliments other health care modalities. We work closely with physicians, alternative practitioners and you, our patient, in order to provide the best and most thorough treatment.
In order to serve you best we encourage you to fill out the form in as much detail as possible. Below, please either download a printable form to bring with you to your first appointment, or complete an online form. Successful health care is when the practitioner has a complete understanding of the patient physically, mentally and emotionally. All symptoms that you are experience are relevant and important to us as Chinese Medicine practitioners. All information will be held in strict confidence.