Nourishing Medicine | Acupuncture, Chinese Medicine, and Massage

New Patient Forms

Patient intake with Elie Cole, L.Ac., LMT

Please download, print, and fill out the three forms below.  Remember to bring them with you to your first appointment.

Health History

Consent Form

Health Privacy Form

Financial Agreement

Only if you have been in a Motor Vehicle Accident (MVA), please fill out these additional forms:

• MVA History Form

• MVA Pain Med Record