Intake Form for the first session

Hello and welcome to Yuan Qi Acupuncture. 

I am looking forward to meeting and helping you soon. In order to win some time on your first appointment and intake, therefore, have more time for the TCM treatment, kindly fill-in and submit the intake form below.

Of course, we can also do this together at your appointment, but then, there will be less time for the treatment. It is totally up to you and what you prefer to do. 

Best of Regards and see you soon.

Cedric

Gender