Client Forms

Please click on the links to download pdfs

Client Intake Form

Release of Information

Blank Food Diary

Office Policies

Element5 Acupuncture has a 24-hour cancellation policy. If you cancel with less than 24 hours, there is a $50 fee unless you re-schedule within the same week.

All paperwork must be completed before treatment.

Please turn off your cell phones while you are in the treatment center.