wang's acupuncture & herbal clinic

PATIENT INTAKE FORMS

Dear New Patient,

Thank you for choosing us for your alternative healthcare needs. To better serve you, we have included a "New Patient Intake Form" for you to print and complete prior to your first visit. 

The form consists of 4 pages in total. Please complete all pages of the form.
This will help ensure our ability to best serve your healthcare needs.

Sincerely,

Wang's Acupuncture & Herbal Clinic

PLEASE NOTICE THAT WE HAVE TWO OFFICES: (BALLANTYNE AREA, CHARLOTTE, NC & ROCK HILL, SC).  


NOTE: PLEASE CHOOSE THE APPROPRIATE FORM BELOW.

onlIne payments

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YOU CAN PAY ONLINE

We offer online payment via PayPal.  All major credit cards accepted.