Forms and Brochures

These are all word documents.  The forms can be downloaded and edited or printed and filled out by hand.


The attached is my practice brochure

This is the techniques brochure

I also have another brochure associated with mental health Issues

Acupuncture Patient

Intake Forms

Please complete all of the following forms before I treat you.  Please print them and fill them out to save time on your first visit.

1. Permission to treat - A basic release to allow me to use needles.

    Please sign both pages.

2.  HIPAA compliance form.  I only need the first page back.

3. Release for your insurance, if you have any that I can bill and

    cancellation policy.

4. Patient intake - your medical history.

Call 646-228-6463 for an appointment.
Abend Acupuncture
5 Willow Place, Ellenville, New York 12428
I See Patients By Appointment Only