Forms

Welcome to our clinic!

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Before your first appointment, please print, fill out, and sign the forms on the right.

Also please read the following to acquaint yourself with our clinic's requirements.
 

Pediatric patients: If you are bringing in your child 12 years of age or younger, please fill out the consent form, financial policy and pediatric health history. Minors ages 13-18 still need to have a parent sign the consent form but may fill out "adult" paperwork.

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What do we ask of you?



Responsibility

We need you to take responsibility for your own health. Please keep yourself hydrated, especially before your treatments. Eat a healthy meal 1-2 hours before your treatment but please avoid coffee, alcohol, sugar, and greasy foods. Wear comfortable loose fitting clothing that you can roll up to your elbows and knees.



Commitment

We ask for a commitment from you to be here when you are scheduled to. If you must cancel or reschedule your appointment, we ask that you give us at least 12 hours notice. We are respectful of your time and we ask that you be respectful of ours – please arrive at least five minutes early for each appointment.

 

Missed Appointment Fees

A $15 fee will be assessed for each missed appointment. We hope you agree that appointments at our clinic are convenient since we're open 6 days a week, evenings and weekends. We hope you also agree that we are an affordable resource, as the median price for acupuncture treatments in Boulder county usually runs an average of $89 per visit. To that end, we're asking you to pay for that convenience and affordability when you miss an appointment. No missed appointment fee is charged if you are sick. 



Credit Policy

As of September 1, 2023, going forward all money held as credit at Left Hand Community Acupuncture needs to be used within 24 months of its payment date or be forfeited. At any time you may request your credit at the clinic be refunded (minus a 20% service charge) or you may donate your credit to patients in need. 

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Animals

With the exception of registered service animals that are wearing vests, please leave your animals at home. Many people have allergies to pet dander. Make other arrangements for your pet as you relax during your session. 

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Flexibility

The community room is relaxing but is not always quiet. There may be other people receiving treatments while you are relaxing into yours. You may occasionally hear the sounds of cars passing, people whispering, a telephone ringing, etc. Please do your best to tune out distractions and focus on what is happening with you and your body. You are welcome to bring an ipod or pillow from home to help you feel more comfortable.



Community-Mindedness

The community room is a calm and relaxing place because you help to make it that way. To help maintain this atmosphere, please turn off your cell phone before entering the room. We also ask that you speak softly to maintain privacy. Please visit the restroom before your treatment so that you may rest uninterrupted.

puncture Therapy Requirements to Expect 

On your first visit

On your first visit please arrive 20 minutes early to fill out paperwork (unless you printed it out and brought it with you!). The acupuncturist will spend some time with you answering and asking questions. After that, you get comfortable in a chair or on a massage table, the practitioner will gently insert needles and you lay back and relax. Some people even fall asleep. The length of time the needles are left in depends upon your body, some people are done after 20 minutes and others may relax for about an hour. Your practitioner will check on you in 30 - 40 minutes. If you need us for any reason, please just cough a couple times or ring the doorbell you have been given. At the end of your treatment your acupuncturist will talk to you about your treatment plan and other plans for care.

Inclement Weather Policy

In the case of heavy snow or other inclement weather, please call the clinic prior to coming to your scheduled appointment. We will leave an announcement about any cancellations on the clinic message. If cancellations are not mentioned, it is safe to assume your practitioner will be here for your appointment. If you need to cancel, please leave a message for us at the clinic as soon as possible. 
 

Thank you again for choosing our clinic – we are happy to have you here.



To your health,
Caroline and the LHCA Team