Patient Forms and Documents


We are constantly adapting our forms and documents to make it easier once you arrive for your appointment.

ACA info picHealthcare Records and the Affordable Care Act (ACA):

Adopting Electronic Health Records (EHR) will soon be required for all healthcare providers as part the ACA. Three Pillars Acupuncture has completed the transition to a completely digital, paperless practice and have been using EHR since July 2018!

This helps us maintain your records securely, improve your ability to access and update your healthcare records and information, and be more environmentally friendly.

The bottom line is that these improvements will make your experience better – when you arrive at Three Pillars clinic, you can simply relax and enjoy your treatment!

 

Download a copy of Three Pillars Acupuncture’s HIPAA policy here:cropped-Three-Pillars-Acupuncture-01-e1468854244671-3.jpg

Three Pillars Acupuncture – HIPAA Notice of Privacy Practices

Required forms for all patients:

*New Patient Registration and Health History

*Informed Consent to Treat

*Assignment of Benefits/Financial Agreement & Cancellation Policy

*Acknowledgment of Receipt of Privacy Practices

These forms are now 100% digital, and must be completed through our online system prior to your first appointment and will be available to you online once you’ve booked an appointment