Patient Forms

Patient Forms for the San Luis Obispo Family Acupuncture Clinic

General Health History

This is for ALL new patients.
click here to download the new patient intake form (PDF)

Fertility Form – For patients with female reproductive organs

If you are coming in for fertility treatments, please fill out this form in addition to the General Health Form.
click here to download the female fertility form (PDF)

Fertility Form – For patients with male reproductive organs

If you are coming in for fertility treatments, please fill out this form in addition to the General Health Form.
click here to download the male fertility form (PDF)

Pregnancy Form

If you are coming in for any pregnancy related symptoms please fill out this form in addition to the General Health Form.
click here to download the pregnancy form (PDF)

Postpartum Form

If you are coming in for an issues related to your postpartum recovery please fill out this form in addition to the General Health Form.
click here to download the postpartum form (PDF)

Basal Body Temperature Charting

How to correctly chart your Basal Body Temperature (BBT) for identifying patterns and problems in your menstrual cycle.
click here to download a printable document about Basal Body Temperature Charting (149K)

Femoral Massage

How to perform a femoral massage to increase your chances of conception.
click here to download a printable document about Femoral Massage (100K)

Castor Oil Pack

The Benefits and How-to’s of doing a castor oil pack at home.
click here to download a printable about the Castor Oil Pack procedure (121K)