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New Patient Intake Forms

 PLEASE NOTE: All patients must wear a face mask the entire time you are in the clinic, including during the treatment time. Please bring your own mask. Cloth coverings are fine. Read our most current Procedures, Policies and Safety Instructions.

*Read Our COVID19 Procedures, Policies & Safety Instructions

Please call our office at 360.449.4500 if you have any questions or need help accessing the Patient Registration and Intake forms. If possible, we prefer that you print the forms and fill them out at home prior to your appointment so that you can take your time.

We have one category of forms, Adult. Please note that Dr. Pete no longer sees patients for acupuncture but he does do phone consultations for parents. If you'd like to learn more about his consultation practice please visit, www.DrPeteHanfileti.com.

New Patient Registration & Intake Forms For An Adult – Age 18 And Above

Lisa Hanfileti, LAc is a licensed acupuncturist trained in Traditional Chinese Medicine. Although she evaluates and determines treatment for all conditions (with some exceptions), her strengths are in treating acute & chronic pain conditions, including arthritis, head/neck/back pain, muscle aches, injuries, post-surgical sequelae, as well as fertility issues, insomnia and mental/emotional imbalances that contribute to a general malaise.  She has additional training in herbal and nutritional support, AcuPatching™, Bioresonance body scans and is certified in Diet & Lifestyle Intervention.

Please click to open all 5 document links below. They should open in your PDF reader so that you can print each one out. (If you need a PDF reader you can download Adobe Reader for free here: Get Adobe PDF Reader.

  1. Adult New Patient Welcome Letter – Read only. This explains what to expect at your first visit.

  2. Adult New Patient Registration & Intake Form – Print, fill out, bring with you

  3. Adult Informed Consent – Print, sign, bring with you

  4. Adult Financial Policies – Print, initial, sign, bring with you

  5. Points of Origin’s COVID19 Procedures & Safety Instructions* – Please READ and follow instructions

If you'd like to learn how to stay updated on the latest coronavirus data as well as local and global resources, please visit our COVID19: What You Need To Know page.