While the Federal Government and the State of Oregon have declared an end to the COVID-19 Public Health Emergency, I encourage all patients to continue to mask. I will be masked at all times in my clinic. 

Address

685 Portland Ave.

Gladstone, OR 97027
 
Clinic Number

(503) 891-2352

Clinic Hours

Saturday  9:00am – 7:30pm

Wed. and Thurs.  3:00pm – 7:30pm

Schedule Appointment

Best Practice Acupuncture

Paperwork

Welcome to Best Practice Acupuncture. It is my goal to help each patient improve their quality of life and achieve optimum health. 

 

Before your first visit, you will need to read, fill out, and sign the following patient forms:

 

  • Health History Questionnaire
  • Cancellation Policy Form
  • Financial Policies Form
  • Informed Consent to Treatment Form
  • HIPAA Notice of Privacy Practices Form
  • Health Insurance Form (whether you have insurance or not)

 

All patient forms are filled out online through a patient portal account you create when you schedule your first appointment.

 

I ask that you complete all patient forms at least 24 hours BEFORE your first visit so that I have time to review them beforehand.

 

If for some reason you are unable to set up an account online, please contact me via email at [email protected].  I will send you copies of the forms by email which you can fill out and bring to your first appointment. Please include your phone number so I can contact you to schedule your appointment. Also, indicate whether or not you have insurance and if your case involves an injury from a motor vehicle accident.  

New Patient Paperwork

If you have regular insurance or are paying out-of-pocket, fill out this form.

New Patient Form

Auto Accident or Work Injury Paperwork

MVC Patients

If you are seeking acupuncture because of a motor vehicle collision, fill out this form.

MVC Patient Form

Workers’ Comp Patients

If you are seeking acupuncture because of an injury on the job, fill out this form.

Work Comp Patient Form

Existing Patient Paperwork

If you have already been treated at Best Practice Acupuncture but have a new injury or condition you need help with, please fill out this form before coming to your next appointment.

Existing Patient Form