ABEND ACUPUNCTURE

Forms and Brochures


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


Brochure

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
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