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

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
440 State Route 32 North, New Paltz, New York 12561
(when using GPS, you really need the word 'North' in the address)
I See Patients By Appointment Only