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New Patient's Form

For all new patients, please print and complete the following forms and bring them with you to your first visit.  You only need to fill these forms once.

- Health History Form

- Treatment Consent Form

- Notice of Privacy Practices Form

- COVID 19 Consent and Agreement Form

Dr Nancy Chau | Wai Acupuncture & Integrative Chinese Medicine of Longwood, Florida

Wai Acupuncture & Integrative Chinese Medicine

Wai Acupuncture Longwood FL

2901 W State Rd 434 #141 Longwood, FL 32779

info@wai-acupuncture.com

(407) 335-4688 (office)

(407) 917-1000 (text)

Clinic hours:

Mon 11 Am - 7 Pm
Tues 11 Am - 7 Pm
Wed Closed
Thurs 11 Am - 7 Pm
Fri 11 Am – 7 Pm
Sat 9 Am – 2 Pm