formsBelow are links to forms that you can download, print, and fill out. You can bring them with you to your first appointment.

The forms listed below are set up as Portable Document Format (pdf)* files. To view and print these files, you will need the FREE Acrobat Reader browser extension or application from Adobe. See below for a link to download Acrobat if your browser does not already include this extension.

If you have any trouble downloading and printing our forms, they are also available at our office. You may either pick them up, or contact us by phone or e-mail if you would like them mailed to you, or fill them out at our office before your first visit.

Patient Health History Forms:


Adults & Children 12 and over

Children under 12

Acupuncture & Herbal Medicine Center
2800 St. Marys Rd. Saint Marys, GA 31558
Appointments: (912) 882-1200

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