Cai's Clinic of Acupuncture and Herbs Consent Form

If you agree with both Pages on the right, Please fill out the below form.

Health Care Provider-Patient Arbitration Agreement. Choosing "YES" means that you Agree and Sign Aritcle 1, Article 2, Article 3, Article 4, Article 5, Article 6 from the form on the right side of this page.
Division of Clinics Informed Consent to Acupuncture/ Oriental Medicine Treatment. Choosing "YES" means that you Agree and Sign with the form on the right side of this page (second form).

Thanks for submitting!