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Information for New Acupuncture Patients: Privacy, Paperwork & Financial Forms

Welcome! I'm looking forward to working with you.

 

Please know that I am always available via phone or email if something arises that you would like to discuss right away.

Paperwork for Your Initial Appointment

To prepare for your initial acupuncture visit, please complete the forms below.

 

Please bring a completed copy of the new patient paperwork with you to your first appointment (I don't need it ahead of time) or email it back to me if you prefer.

If you do not have a printer, and you want to fill this document out by hand on-site, please drop me a line or email me to let me know, and I will have a printed copy ready for you 15 minutes before your scheduled appointment time. 

How to Prepare for Your Appointment and What to Bring with You

Please eat lightly (don't come on an empty stomach).

Please wear loose comfortable clothing.

In addition to bringing the completed paperwork with you, please bring your calendar so that we can schedule follow-up appointments. 

At your first appointment, we will discuss your treatment goals and work together to set benchmarks so that you can know how acupuncture is helping you. We will also have plenty of time for acupuncture during this initial session.

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Financial Policy

I prefer cash, check, or FSA/HSA (Flexible Spending or Health Savings Account) cards, and I also accept credit cards.

You can download and review my complete financial policy using this link below. We will review this policy in person at your initial appointment.

Stay connected with seasonal health tips, workshop opportunies and strategies to help you recover your wellbeing, reclaim your energy & thrive. 

Restore your wellbeing with the wisdom of Five Element Acupuncture.

215-500-2579         Email me here.

Offices in Center City Philadelphia: 255 S. 17th Street, Suite 1502, Philadelphia, PA 19103 

West Philly Acupuncture: 4522 Baltimore Avenue, Philadelphia, PA 19143

©2014-2026 by Acupuncture with Monica, LLC, Monica Fauble, M.A., M.Ac., L.Ac., Dipl.Ac. (NCCAOM), CYT-500

All Photos (except Buddha statue photo) ©Hanbit Kwon

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