Medical Equipment Repair and Medical Equipment Maintenance Sunbury Selinsgrove Northumberland PA 12582 South Fort Street
Draper, UT 84020

Downloadable Forms

All new patients and/or prospective patients are required to complete all pages of both forms below prior to any Intake & Consultation, and/or treatments. Please bring the completed forms to your first appointment.

New Patient Intake Health History – form

Informed Consent – form

Thank you!

Randy Sorenson, L.Ac.

Master of Science – Oriental Medicine

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