Berkley Acupuncture

Forms needed for your first visit:

Below are necessary forms needed in order to receive acupuncture. For certified Acupuncturists, forms are a necessity to ensure that both parties involved are knowledgeable of the service and are protected. If you like, please print and fill out the forms prior to visitation. Also, check out the insurance carriers listed to see if you may qualify!

Consent Form:

PDFthumb_Consent-Form The Consent form lets you know about the treatment prior to having it as well as allowing us to be able to provide the service to you.

Mandatory Disclosure Form:

PDFthumb_Mandatory-Disclosure-Statement The Mandatory Disclosure Statement is to make sure you are aware of necessary items such as cost.

Intake Form:

PDFthumb_Intake-Form The Intake form is necessary any time you are a new patient.