Bringing Your Health Back to Balance

Patient Forms

Please complete these form before arriving and return it to us at your first visit.  This important information enables us to provide you with quality patient care.

In addition please bring any labs or pertinent information that will help us provide the most effective treatment for you.

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New Patient Form

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ADDRESS

icon-home   Smithtown Acupunture and Wellness

       20 Gilbert Ave.

       Smithtown, NY 11787

icon-phone 631-265-5656

icon-envelope   info@smithtownacupuncture.com

 

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