New Patient Forms

Congratulations! You have just taken the first step to better health. Please download our New Patient Forms below, fill them out and bring them to your first appointment. This will allow us to focus the entire first session on getting to know you and your history, not on paperwork. If you are unable to fill out the forms at home, you may request that we e-mail them to you or ask us to leave them for you at the front desk on the day of your first visit. It will take you about 20 minutes to fill out the forms in our office, so please plan accordingly.

Important:  Treatment cannot begin until all of your forms are received and signed.

New Patient Forms 2013

Fertility Testing and Treatment History(fertility patients only)

If you have to change your first appointment for any reason, please give us 24 hours notice so that we can give that appointment to a patient on our waiting list.

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    It is with much gratitude that I write this testimonial on behalf of Julie Permut’s intuition and skills in the field of acupuncture. I truly enjoy traveling to places near and far. However, because I experience light vertigo and intense nausea while flying the idea of going to those distant places causes great anxiety for me as I know what is to come when I buckle up and prepare for that ascension into the clouds. I decided to seek acupuncture as a means to alleviate the nausea, vertigo, and flight anxiety. After assessing my situation holistically, Julie created a treatment plan to address all three of the issues that had impeded my ability to fully experience the joy in traveling. Since undergoing treatment with Julie, I have traveled by plane without any symptoms. Her treatment was gentle and had no side effects, unlike the multiple standard western medicine treatments that I had attempted prior to seeking Julie’s services. I owe Julie more than I can express as she has supported my ability to travel with pleasure.

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