Partners In Health Acupuncture

Partners In Health Acupuncture in Kenosha, WI with Linda Stengel, Certified Acupuncturist

Patient Forms

Thank you for choosing Partners In Health for your treatment.  In advance of your initial appointment, please complete the health history and consent forms on the link below.

 

Please answer the questions as completely as possible to save time during your appointment.  List all the medications you are taking, whether they are prescriptions or supplements.  Allow 90 minutes for your first visit; subsequent treatments will last between 45-60 minutes.  Following are a few guidelines for your treatments:

  • Wear or bring loose, comfortable clothes (pants that slide easily above your knees and a V-neck tee shirt, tank top, or button-down shirt (women: no pantyhose)
  • Eat a light meal before your appointment
  • Refrain from brushing your tongue two days before your appointment
  • Refrain from chewing gum/lozenges/breath mints an hour prior to your appointment
  • As some of our patients have chemical sensitivities, please refrain from wearing heavy perfume or cologne.

       To ensure that you are able to benefit fully from acupuncture, you will likely be treated multiple times within the first few weeks.  Partners In Health offers a unique cost structure that allows you to choose how much you are able to pay (between $20-$50) for each visit, plus $10 for your initial appointment (cash or checks only).  Please bring your calendar so you can schedule your next appointment before you leave the clinic.  If you are unable to make your appointment, please note that I have a 24 hour cancellation policy to avoid a charge and so that others might benefit from your reserved time.  As a courtesy to other patients, please silence your electronic devices when you enter the clinic. 

 

I look forward to working with you and being your partner in health.

 

Download Medical History and Informed Consent Forms to bring to your first acupuncture appointment.  To save time, feel free to email the forms to me in advance of your first appointment.

If this is your first massage appointment with Partners In Health, please download this form and bring to your appointment: First-time Massage Health History form.

Associated Bodywork & Massage Professionals
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