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Hermits Point Medicine
Acupuncture, Auras & Advocacy

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Treatment Forms

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If you are under the care of a physician or specialist, a doctors' note will be required before treatment.Required Forms for Acupuncture Therapy and adjacent health appointments.

1. New Patient Intake Form
2. Consent to Treatment Form
3. Colorado Mandatory Disclosure Form

Additional Forms, as Needed

AR. Release of Medical Records Authorization Form
FR. Request for Reduced Fee Form

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