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Health History Form

Please click the button below to be taken to the HB Acupuncture Health History form. Please complete as comprehensively as possible.

Health Questionnaires

# File Description File size
1 Fertility Treatment Form Please download the Fertility Treatment form and save as FirstName.LastName.pdf. Please now open the PDF using Adobe Acrobat Reader . There is a link to download this application at the top of this page. Please complete the form ideally typing with your PC/MAC. You can also print and write. As you move forward filling in the information using a PC/MAC, it is suggested that you save periodically so as not to lose your work. Once finished, please email to [email protected].
280 KB