☰ Magnolia Acupuncture & Herbal Clinic

Forms


1. Notice of Privacy Practice (2 pages)

2. HIPAA Authorization for use or disclosure of health information (3 pages)

3. Consent Forms
  • Acupuncture (1 Page)
  • Chinese Herbal Medicine (1 Page)
  • Treat Minor Children (1 Page)

    • 4. Telehealth (eHealth) Consent Forms (2 pages)

    5. New Patient Forms with Acknowledgement and Questionaire (6 to 7 Pages)

    6. COMPILATION OF ALL FORMS











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