Intake Form (New Patient ONLY)

Take your time and ensure each question is answered in detail.

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This form will provide the necessary information for preparing your acupuncture treatment, herbal formula, or a combination of both.

 

Traditional Chinese medicine views the human body holistically, offering a highly personalized approach to healthcare.

 

The more detailed information you provide about your physical condition, the more precise your treatment plan will be.

 

Once completed, please email it to info.cmtic@gmail.com

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Thank you!