You may email completed forms to email@example.com or bring a printed copy to your appointment.
Selby Acupuncture Intake Form
Use this form if you are coming for your first acupuncture or shiatsu massage visit.
Intake Form — Download PDF
Female Fertility Intake Form
Female fertility patients, please use this form.
Female Fertility Intake Form — Download PDF
Review our HIPAA (Health Insurance Portability and Accountability Act) Policy here:
Notice of Privacy Policies — Download PDF