Complete Our New Patient Form

At Shasta Acupuncture it is our goal to help each patient improve their quality of life and work together to achieve health goals. In order to best serve you we encourage you to complete the form in as much detail as possible. Please download the printable form below, complete, and email to info@shastaacu.com. Please note, your first appointment cannot be scheduled until we receive a completed form, All information will be held in strict confidence.

Call our Klamath Falls office at (541)884-1952 for more info on scheduling your initial consultation and treatment.