Patient Forms

We would like to take a moment to welcome you as a new patient of Acupuncture Associates of Long Island.  Thank you for choosing us.  We look forward to partnering with you to address your health concerns, and will do all we can to ensure that you achieve the most successful result possible for you.

To save time on the day of your treatment we recommend that you print and complete each form appropriate to you.  Please either fax back to a secure line to (516) 513-1195 or scan and e-mail back to us This email address is being protected from spambots. You need JavaScript enabled to view it. any patient intake forms for us to review before your scheduled appointment.

If you cannot fax or e-mail please fill out the forms and bring with you the day of your treatment or drop it off at our office prior.

Please take the time to read and browse the welcome letter, our frequently asked questions, privacy practice, and tips for before and after your acupuncture treatment!

We look forward to meeting with you.

Yours in Health and Wellness,

JoAnn and Jodie

Initial Forms for All Patients

pdfAALI-INTAKE-for-All-Patients.pdf164.67 KB

pdfAALI-PrivacyPolicy.pdf168.63 KB

pdfAALI-Welcome-Letter-for-All-Patients.pdf74.41 KB

pdfTips-Before-After-Acupuncture-Treatment-for-All-Patients.pdf74.33 KB

Forms for MEI Zen Face, Neck and Abdomen Cosmetic Patients Only

pdfAALICosmeticWelcomeLtrInstructions.pdf197.14 KB

pdfCosmetic-FACE-NECK-Intake-for-MEI-ZEN-Patients.pdf257.49 KB

Forms for Pediatric Patients

pdfPediatric-Intake-0-12yo3.pdf