Welcome Aboard!
We are honored that you have chosen to make an appointment with us and will do everything in our power to make your experience both joyful and meaningful. Please fill out the intake form below so that we can prepare ahead for your visit and provide the best care possible. Thank you!

NOTE: Please do not fill out this form on the same day of your appointment since we do not have access to the internet at the clinic. If your appointment is on the same day, simply fill our this form at our clinic. Thank you for understanding!

    If acupuncture is covered under your insurance plan, please bring your insurance card with you. If your visit is accident related, please provide accident insurance information (accident insurance company name, agent, date of loss, and claim number) upon arrive for your first treatment. If you are unsure of whether or not acupuncture is covered under your plan, please contact your insurance provider for plan details.

    Please call us to make an appointment after filling out this form at (503) 722 - 5224.
    We look forward to serving you soon! (Click below to submit your intake form)