Forms

Download and print these forms prior to your first office visit to Acupuncture Associates.
If you prefer, forms can be mailed to you, call 910.798.8181 to receive a welcome packet.

For Acupuncture: Adobe Reader:
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to read .pdf files.
Confidential Patient Information Form* .pdf
Primary Contact Form* .pdf
Patient Consent Form* .pdf
Acknowledge Receipt of Privacy Practices* .pdf
*Required for 1st Visit
For Infertility:
Basal Body Temperature (BBT) chart .pdf
Article on Taking Your Basal Body Temperature
For Stop Smoking:
Stop Smoking Patient information Sheet .pdf
For Your Information:
Self Assessment Profile .pdf
Notice of Privacy Practices .pdf
Know Your Acupuncturist .pdf