For All Patients:

Please review my HIPAA policy.

EnPointe HIPAA Disclosure v2.pdf EnPointe HIPAA Disclosure v2.pdf
Size : 162.998 Kb
Type : pdf

New Patients:

Please download, print, and complete the following forms.  Bring these forms to your first appointment.  Thank you!

EPA Patient Information Form.pdf EPA Patient Information Form.pdf
Size : 104.313 Kb
Type : pdf
EPA Informed Consent.pdf EPA Informed Consent.pdf
Size : 117.368 Kb
Type : pdf
EPA Patient HIPAA Acknowledgement.pdf EPA Patient HIPAA Acknowledgement.pdf
Size : 136.584 Kb
Type : pdf
EPA Health History Form.pdf EPA Health History Form.pdf
Size : 184.445 Kb
Type : pdf

New acupuncture patients referred by Vestal Chiropractic:

Please download, print, and complete the following forms.  Bring these forms to your first appointment. Thank you!

Vestal Chiro Patient Information Form.pdf Vestal Chiro Patient Information Form.pdf
Size : 119.604 Kb
Type : pdf
Vestal Chiro Informed Consent.pdf Vestal Chiro Informed Consent.pdf
Size : 138.308 Kb
Type : pdf
Vestal Chiro Patient HIPAA Acknowledgement.pdf Vestal Chiro Patient HIPAA Acknowledgement.pdf
Size : 156.678 Kb
Type : pdf
Vestal Chiro Center HIPAA rel of info.pdf Vestal Chiro Center HIPAA rel of info.pdf
Size : 214.65 Kb
Type : pdf
Vestal Chiro Health History Form.pdf Vestal Chiro Health History Form.pdf
Size : 193.671 Kb
Type : pdf