New Patient Forms

For Initial Appointments at my Dupont Circle office

Please complete the forms below prior to your New Patient Virtual Intake.

Health History Intake Form

Consent Form and Policies

Telehealth Consent Form
Because I am now doing all intake conversations virtually, including the new patient intake, all new patients will also need to sign the telehealth consent form.

Notice of Privacy Practices

For Virtual Wellness Sessions

Established patients: please sign and initial the form below. This secure form can be filled out and submitted online.

Telehealth Consent Form for Established Patients

New patients: if you would like to discuss whether virtual sessions are the right fit for you, please set up a free phone consultation via my online scheduler. Once you book your first Virtual Wellness session, please complete the form below prior to your session.

Telehealth Consent Form for New Patients Initiating Virtual Wellness Sessions

New Patient Forms - Nurturing Spirit Acupuncture in Washington, DC, Dupont Circle, Arlington, VA, Ballston

The Teal Center for Therapeutic Bodywork
2:00 - 6:00 p.m.
4001 N. 9th St., Suite 230
Arlington, VA 22203
Ballston Metro

I am not taking any new patients at the Teal Center. Through September 2020 I will have occasional Tuesday availability for established patients.

1633 Q
1:15 p.m. - 7:00 p.m.
1633 Q St. NW, Suite 200
Washington, DC 20009
Dupont Circle Metro, Q St. exit

I have resumed office visits at my Dupont office on Fridays.