Patient Forms
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​All patient information and fees are found in the documents below.
 
Please  fill out the new patient form prior to first appointment.

All fees are specific to each office refer to either Santa Cruz or Los Gatos for your fee schedule. 

All appointments are reserved especially for you.

Cancellation fees apply for appointments canceled with less than 48 hour's notice.
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Please contact me with any questions regarding billing, fees, or payments.

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New Patient Form Please print, fill out and bring to your first session:

new_patient_essential_health.pdf
File Size:	201 kb
File Type:	pdf

Download File

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Patient welcome letter please read

practice_welcome_letter.docx
File Size:	113 kb
File Type:	docx

Download File

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Office policies and Fee schedule Los Gatos Clinic

patient_policies_los_gatos_clinic.pdf
File Size:	83 kb
File Type:	pdf

Download File

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Office Policies and Fee Schedule Santa Cruz

policies_santa_cruz_clinic.pdf
File Size:	84 kb
File Type:	pdf

Download File

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HIPAA Privacy Statement

essential_health_hiipa_statements.pdf
File Size:	110 kb
File Type:	pdf

Download File

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Get The Most Out Of Your Sessions By:

• Arriving on time
• Wearing loose clothing for easy access below elbows and knees, possibly abdomen
• Eating a light meal so you don’t arrive hungry
• Refraining from alcohol or recreational drugs before treatment.  Intoxicated treatment will be refused with charge.
• Keeping your treatment plan as acupuncture’s effects are cumulative
• Between visits, making notes of changes in your condition.