Moss Acupuncture & Massage
The gold standard for acupuncture in Northeast Portland.
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Please Bring a
Completed
Patient Medical History Form
to your initial appointment-- it will hasten the intake process
PLEASE DO
NOT
use double sided printing.
Its a law, thanks.
Please download, complete and bring this
MEDICAL HISTORY FORM
to your initial visit.
I
f you have problems downloading this form
Or don't have access to a printer
email me anytime at
health@mossclinic.com
and I will be glad to email or mail them to you the old-fashioned way-- as long as you live near Portland, Oregon.
Your email needs to include your name and MAILING address, please.
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