Patient Forms

If you would like to do so, you may print and fill out your intake paperwork ahead of time and show up at your scheduled appointment time with the paperwork completed.  Otherwise, please arrive 15 minutes before your appointment time to fill out the paperwork at the facility.

If you would like to complete your paperwork ahead of time, please click on each link below to print out the patient information forms (all forms below are required).

You may fax the forms to us at 303-655-8698 or bring the paperwork with you to your initial appointment.

Please be sure to complete every line of the patient information section.  This will speed up the verification process of your insurance benefits.  Also, the insurance company's telephone number is very important and can usually be found on the back of your insurance card.

If you have any questions please call us at 303-655-8699 or contact us.

Download Patient Forms: All patients please fill out the first two forms below, and any of the other forms per the instructions below.

• Clinic Policies Form
• Medical History Form
• Acupuncture Patient's Please fill out this Medical Screen Form instead of the above. Fill out this disclosure form as well.
  
• Please fill out the corresponding form below to what body part you are seeking treatment for.  Please select all that apply.
• Neck
• Arms/shoulders/upper extremity
• Legs/Hips/Lower Extremity
• Back
• If you plan to pay for your services and NOT use Insurance please fill out the form below.
• Private Pay Agreement
• If we did not get your demographic and insurance information over the phone; please print and fill out the form below.
• Patient Intake Form