Acupuncture Issaquah
  • Home
  • About Us
    • Christina Jackson, DAHM, AEMP, LAc
    • Mariko Johnston, MS, AEMP, LAc
    • East Asian Medicine >
      • Acupuncture
      • Chinese Herbal Medicine
    • Clinical approach
    • Mentoring Program
  • Areas of Expertise
    • Fertility >
      • Our Approach
      • Fertility Conditions Treated
      • How acupuncture helps
    • Pregnancy >
      • Trimesters
      • Postpartum
    • Chronic health conditions
    • Women's Health and Gynecology
    • Preserving health and immunity
  • Appointments
  • For Patients
    • Patient Portal
    • Fullscript Pharmacy
    • Insurance and billing
    • Preparing For Your First Visit
    • Location and Directions
    • Fee Schedule
    • Contact
  • Home
  • About Us
    • Christina Jackson, DAHM, AEMP, LAc
    • Mariko Johnston, MS, AEMP, LAc
    • East Asian Medicine >
      • Acupuncture
      • Chinese Herbal Medicine
    • Clinical approach
    • Mentoring Program
  • Areas of Expertise
    • Fertility >
      • Our Approach
      • Fertility Conditions Treated
      • How acupuncture helps
    • Pregnancy >
      • Trimesters
      • Postpartum
    • Chronic health conditions
    • Women's Health and Gynecology
    • Preserving health and immunity
  • Appointments
  • For Patients
    • Patient Portal
    • Fullscript Pharmacy
    • Insurance and billing
    • Preparing For Your First Visit
    • 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



All rights reserved
Acupuncture Issaquah,
Christina M Jackson, DAHM, AEMP, LAc
​contact