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Intake Forms

Please print, fill out and bring it with you to your appointment.
Most important are the sections about your symptoms, your Medication/Allergy list and what helps or makes your symptoms worse. As for the rest of the form, fill out as much as you feel comfortable with.
I look forward to seeing you!

Eagle Acupuncture

In the Healing Sanctuary

672 Exton Commons

Exton, PA 19341

Tel: 610-304-0705

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© 2022 by Eagle Acupuncture

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