Acupuncture Issaquah
  • Meet the practitioner
    • Clinical approach
    • Curriculum Vitae
    • Mentoring Program
  • East Asian Medicine
    • Acupuncture
    • Chinese Herbal Medicine
  • Areas of Expertise
    • Fertility >
      • Christina's Approach
      • Fertility Conditions Treated
      • How acupuncture helps
    • Pregnancy >
      • Trimesters
      • Postpartum
    • Women's Health and Gynecology
    • Chronic health conditions
    • Preserving health and immunity
  • For Patients
    • Appointments
    • Pay A Bill
    • Insurance and billing
    • Preparing For Your First Visit
    • New Patient Forms >
      • Insurance Benefits Verification
    • Location and Directions
    • Fee Schedule
    • Contact
  • Meet the practitioner
    • Clinical approach
    • Curriculum Vitae
    • Mentoring Program
  • East Asian Medicine
    • Acupuncture
    • Chinese Herbal Medicine
  • Areas of Expertise
    • Fertility >
      • Christina's Approach
      • Fertility Conditions Treated
      • How acupuncture helps
    • Pregnancy >
      • Trimesters
      • Postpartum
    • Women's Health and Gynecology
    • Chronic health conditions
    • Preserving health and immunity
  • For Patients
    • Appointments
    • Pay A Bill
    • Insurance and billing
    • Preparing For Your First Visit
    • New Patient Forms >
      • Insurance Benefits Verification
    • Location and Directions
    • Fee Schedule
    • Contact

New Patient Forms

The following two forms must be completed by all new patients. They may be printed out and completed prior to the first visit, or you may arrive 15 minutes early and complete them before your appointment.

Intake Form For New Patients

Consent Form and Privacy Policy


Other forms
Insurance Benefits Verification Forms

Patient Authorization of Medical Information Release form

BBT Chart

BBT Chart Instructions


Appointments
Meet the Practitioner
East Asian Medicine

Areas of Expertise
For Patients
Pay a Bill
Contact
Map & Directions


All rights reserved
Acupuncture Issaquah, 
Christina M Jackson, L.Ac., P.S.