Get New Patient Forms Pdf - Triangle Acupuncture Clinic

Filling out the New Patient Forms is a crucial step towards receiving personalized care at Triangle Acupuncture Clinic. This guide provides detailed instructions on how to complete the forms accurately and efficiently online to ensure your information is captured correctly.

Follow the steps to complete your New Patient Forms online.

1. Press the ‘Get Form’ button to access the New Patient Forms PDF and open it in your preferred editor.
2. Begin with the contact information section. Fill in your name, today's date, street address, primary and secondary phone numbers, city, state, and zip code. Indicate whether your phone numbers are home, work, or cell by circling the appropriate option.
3. Provide your email address and the name and phone number of a contact person to reach in case of an emergency.
4. Answer the question about how you heard about the clinic and the name of the person who referred you, if applicable.
5. Indicate your marital or relationship status, birth date along with your age, occupation, height, weight, primary physician's name, sex, and date of last visit.
6. Describe the main issue you wish to address and note when your first symptoms began. Reflect on past factors that may have contributed to your condition and any diagnosis you have received from your healthcare provider.
7. List the treatments, drugs, or therapies you have tried along with their success rates. Detail your healing goals regarding this condition and any major stressors in your life.
8. Complete the sections about tobacco, caffeine, alcohol, and recreational drug use by indicating frequency and amounts. Also, list all vitamins, supplements, and medications you are currently taking, including dosages and reasons for taking them. Use additional space if necessary.
9. Document any known drug allergies and detail your past medical history, including major illnesses and surgeries, along with their dates.
10. For female users, provide the date of your last PAP and last mammogram.
11. Fill out the family medical history by checking applicable conditions for yourself and your family members (mother, father, siblings, spouse, and children).
12. Finally, make sure to review all entries for accuracy and completeness. Once finished, you can save changes, download, print, or share your completed form as required.

Start filling out your New Patient Forms online today to prepare for your visit to Triangle Acupuncture Clinic.