Forms and Handouts

Below are links to forms that you may download, print, and fill out. You may fax, mail, or email these forms to the Acupuncture Clinic of Boulder, Inc. prior to your appointment at 303-665-5832 or bring them with you to your first visit.

 

Required For Your First Visit:

Initial Intake Forms (Download Required)

Consent for Treatment and Disclosure Statement

 

HIPPA privacy policy (optional to download)

Fertility Forms:

Women’s Body Temperature
Recommendations for Conceiving
Women’s Fertility History
Men’s Fertility History

Handouts:

Recommendations for Conceiving
Protein Chart
Foods to Help with Constipation