Patient forms for West End Eastern MedicineIf you are a new patient, please print, fill out and bring the following forms with you for your first appointment. Please click this link to download the forms in PDF format that can be easily printed. You can also click the picture to the right to get the forms!

Office Policies


All patients are seen on an appointment basis. Please call well in advance so we can reserve time for you. Please be aware that the full treatment fee will be charged for broken appointments unless a 24-hour business day notice is given. This means for a Monday appointment notice needs to be given by Friday at 5:00 PM. It is the patient’s responsibility to remember an appointment. Reminder calls are made only as a courtesy.


We make every effort to keep the cost of care down. To assist this effort, you are expected to pay upon the completion of each visit. We accept MasterCard and Visa, debit cards, checks or cash. We request a $20 minimum purchase for credit card charges. A $25.00 fee will be charged on all returned checks.

Chinese Herbal Formula Refills

We kindly request a minimum of a 72 hour notice for herbal refills.


We do not bill insurance. We will be happy to assist you with filling out any relevant insurance claim forms but payment is expected after each visit. After filing your claim, your insurance carrier may reimburse you. Acupuncture is covered under Health Savings Plans and some Medical Savings Accounts. Chinese herbs and supplements are not covered under any insurance plan.

Thank you for calling this office. It is a pleasure to be of service to you.

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