New Patient Forms

After you have made your appointment for either Naturopathic Medicine and/or Acupuncture, you can download your forms here, print them out and fill them in for us before your appointment. If you would prefer to have them sent in the mail, just let us know. Still do try to come at least 10 minutes early to your appointment to give Dr. Becker time to review your paperwork. Also, remember to bring any pertinent lab work and current medications and supplements with to your first appointment.

Download

New Patient Forms (4):

1) Welcome Letter

2) Clinic Procedures and Policies

3) Adult Health History Form

4) Pediatric Health History Form                                                                          

***New Patient forms for the Evansville Community Acupuncture program can be found here: www.evansvillecommunityacpt.com