Oriental Medicine Associates

Affordable Alternative Health Care

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Please download, print and fill out the following forms, and bring them with you to your first appoinment.  The Privacy Policy is for your information only, and need not be brought in. Please sign all forms unless otherwise indicated.  If you do not have a working printer, forms are available in the office.
 
 
Notice of our Privacy policy                                               Privacypolicy.doc  (no signature required, for your records only)
 
HIPPA Privacy acknowledgement                                      HIPAA release.pdf
 
Notification regarding evaluation by physician                      NotificationPhyEval-converted.pdf
 
Patient Intake Form (2 parts)                                             PtIntake-converted.pdf       PtIntake2-converted.pdf
 
Informed Consent to Care                                                  New Informed Consent.pdf
 
Arbitration agreement                                                        Arbitration-converted.pdf