New Patient Forms

Acupuncture Clinic Paperwork [Download PDF]

Privacy Policy and Arbitration Agreement are for your records and do not need to be completed or brought to the clinic. If you have problems downloading forms, please call the clinic receptionist; we will be happy to fax them to you. Find out more about what to expect at your first visit.

Please print and complete either the brief or complete health assessment paperwork including the HIPAA form. The Notice of Privacy Policies is for your records and do not need to be completed or brought to the clinic. If you have problems downloading forms, please call the clinic receptionist; we will be happy to fax them to you.

Dr. Jennifer Pollard Paperwork

Download Dr. Jennifer Pollard Paperwork

Please print and complete the health assessment paperwork including the HIPAA form. The Notice of Privacy Policies is for your records and do not need to be completed or brought to the clinic. If you have problems downloading forms, please call the clinic receptionist; we will be happy to fax them to you.

Professional Clinic - North
2700 W. Anderson Lane, #512
(512) 467-0370, Fax (512) 454-8846
aoma-clinicstaff@aoma.edu
Map & Directions

Professional Clinic - South
4701 West Gate Blvd, Bldg. A
(512) 693-4373, Fax (512) 492-3098
aoma-clinicstaff@aoma.edu
Map & Directions