New Patients

 

Thank you for choosing Brielle Acupuncture Center for all of your holistic healthcare needs!  Before you visit our office for your first appointment, please fill out the following forms and bring them with you so we will have all of the information needed to appropriately treat your condition.

 

* If you are a male patient, please fill out the Initial Acupuncture Intake form

**If you are a female patient, please fill out the Initial Acupuncture Intake form and Women's Health form

***If you are a female patient coming for treatment pertaining to fertility, please fill out the Initial Acupuncture Intake form, the Women's Health form and the Women's Fertility form

Please be advised: All paperwork must be printed, completed and brought to your appointment or we will need to reschedule


We reserve the right to cancel your appointment if you are late for your appointment time.  We suggest arriving 10-15 minutes early to relax and prepare for your visit.

 

If you have any questions, please don't hesitate to call.  We are looking forward to meeting you!