Mark Abelle, Diplomat of Acupuncture Ashland Oregon
Acupuncture Clinic Traditional Asian Medicine Ashland Oregon
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Acupuncture, Ashland OR
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Click any of the form names below to download. Adobe Acrobat Reader is required to view the forms. You can download a free version here.
Patient Registration Information
Informed Consent for Acupuncture Treatment
Comprehensive Acupuncture
Analogue Pain Scale
Patient Symptom Survey
Pattern Discrimination Check List
Patient Questionnaire
Menstrual Cycle Diary and BBT Chart
Consent to Treatment of Minor		 Food Diary
Entry Diet Report
Food Inventory
Daily Food and Feelings Diary
Notice of Privacy Practices
Notice of Privacy Practices--Acknowledgement
Phone Verification of Insurance Coverage
Authorization to Disclose Healthcare Information

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