New Patient Intake Form
(Fillable PDF Download)

A professionally structured intake form designed specifically for TCM and acupuncture practitioners.

Collect comprehensive clinical information before the first visit, including: chief complaint, medical history, lifestyle factors, musculoskeletal pain patterns, all TCM systems, female/male health, fertility, digestion, sleep, emotional health, pulse/tongue notes, diagnosis, and treatment planning.

Why practitioners use this form:

⏰ Save time on every new patient intake

✅ Gather clearer, more complete diagnostic information

💡 Improve clinical efficiency and treatment outcomes

What you get:

📩 Instant download

📄Fillable 6-page PDF

✍🏼Print or use digitally

♾️ Unlimited patient use

💻Endless downloads on multiple devices

A simple upgrade that improves your intake process immediately.

👉 Download now and use with your very next new patient. 

⚠️Due to the nature of digital downloads, all purchases are non-refundable.

🤔 Questions? Email acuproacademy@gmail.com