Intake Form | Events

Intake& Consent | Jing Shen Healing Arts | Ancient Ways Apothecary | Middle Path CrossFit | Community Events

I. General Information


II. CAUTIONS | POTENTIAL CONTRAINDICATIONS

In the last 3 months, have you experienced any of the following? **Checking YES does not preclude you from participation. However, it prompts further discussion with one of our providers**


III. PERSONAL CHECK IN

Please check any boxes if you are currently experiencing or have experienced any of the following symptoms or if you have received a diagnosis of any of the following conditions in the last 3 months.


The "PERSONAL CHECK-IN" section is just a small sample of the things we treat within our clinic regularly.

We offer 30 minute consultations | If you checked one or more of the above boxes and would be interested in knowing if/how we can help you address the symptoms marked above, then please consider speaking with one of the the Doctors of Acupuncture and Chinese Medicine at Jing Shen healing Arts.  Discover how a more  personalized approach to care can you get back to feeling like yourself NATURALLY & HOLISTICALLY with minimal side effects!

Please keep in mind, this is just a small list of what see and resolve consistently within regular treatment sessions at our clinic. Below is a list of offerings that we can use to design a TREATMENT PLAN specific to your personal needs!


CURIOUS ABOUT OUR OFFERINGS?


TERMS & CONDITIONS

(read through and accept below)