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Initial Intake Form pdf - Light Joy Acupuncture

Initial Intake Form pdf - Light Joy Acupuncture 2026

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The document is a comprehensive confidential patient record form used by a chiropractic and acupuncture clinic. It collects personal information, health evaluations, lifestyle habits, medical history, family history, and informed consent for treatment. The form emphasizes the importance of privacy regarding health information and outlines the risks associated with chiropractic and acupuncture treatments. Additionally, it includes a notice of privacy practices detailing how patient information may be used or disclosed.

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