Policies & Forms

HIPAA and Your Privacy

In accordance with privacy law, what is discussed between the patient and the practitioner during session, and the patient's written records remain strictly confidential. The patient may request a copy of his or her records in writing. For further information on patient confidentiality, please see http://www.hhs.gov/ocr/hipaa/.

Cancellation Policy

Upon scheduling an appointment, we at Heart of Acupuncture prepare for your visit with an intention to create a healing space and time specifically for you. If you are unable to make your appointment or need to reschedule, we ask that you provide us at least 24 hours advance notice. We ask for your understanding and a full payment for any appointments missed without a munimum of 24 hours advance notice. To reschedule or cancel an appointment, please call 415-797-8299.

Initial Consultation Form

Heart of Acupuncture offers a holistic approach that treats the whole person. The information requested on the following pages will help us to do our best in serving you. We ask that you print out and complete the form as best as you can. Please bring the form with you to your initial consult and treatment.

© 2017 Heart Of Acupuncture.                                                    801 7th Street  Santa Rosa, CA  95404                                                               415-797-8299

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