New Patient Forms Welcome to our practice.
Please print and fill out the following forms and bring them with you to your scheduled appointment.
Acupuncture FAQ or Herb FAQ
Patient Information Sheet
Please fill out the form. Sign where is requested. At the bottom of the form please indicate up to 2 people (not including your physicians) to whom we
are authorized to discuss your medical information with and sign. If there is not one that you authorize, just write "NO ONE", sign and date.
Patient History Form and Pain Assessment Chart
Fill out the forms regarding your medical history as thorough as possible. At the front of the page, please indicate your reason to see Dr. Sheng under Reason
Visiting this Office.
If you have no pain, please note "No Pain" on the Pain Assessment Chart and sign at the bottom of the form.
Fee Policy
Please read the policy, sign and date where it applies to your visit.
Notice to Privacy Practice & Acknowledge Form
The first page is regarding the privacy practice we adopt in this practice. This is for you to keep.
On the second page, please fill out your name, sign
and date and bring this with you to your appointment. This form indicates your acknowledgment of the privacy practice.
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