Quick links

Patient Info

You may schedule an office visit either by phone or by using the online appointment request form below.

To schedule an office visit by phone dial: 1-877-700-GETWELL or simply click on the calender banner below. You will be instantly connected with our office.

All web form appointment requests will be confirmed by return e-mail the same day we receive your request. We attempt to respond to all requests to speak with the Acupuncturist within 2-3 hours.

How Do I Become a Patient?

Call our office or Fill out our short appointment request form below
Download our Patient Health history form and bring it with you to your first visit
Please see our video below: How To Prepare for You First Acupuncture Visit

Appointment or Request to Speak With the Acupuncturist Form

Tell us about you


I am :
	The person seeking treatment, second opinion A friend or family member

Reason :
	Appointment request Wish to speak with the Acupuncturist

Name *

Address *

City/Town *

Country *

State/Province *

Zip code *

Gender *

Date of Birth *

Resi. Phone *

Work Phone *

Have you ever been treated at our clinic before?

Email-ID :


Reason for Appointment or call
	General Check Up / Follow up Visit New Treatment / My complaint is: (briefly describe)


	Please enter date and or time requested for appointment or enter yes for earliest available and we will contact you with those times Please see our clinic hours Enter "Yes" in Earliest Available line if you wish us to contact you with the earliest available times and "Yes" in the Office location for your visit.

Date :

Time :

Earliest Available :

* Denotes required fields