Acupuncture Patient Consent & Intake Form

Streamline Your Acupuncture Practice with a Digital Patient Consent Form

For acupuncture clinics and Traditional Chinese Medicine (TCM) practitioners, thorough patient intake and informed consent are essential—not just for compliance, but for building trust and delivering personalized care. This Acupuncture Patient Consent & Intake Form template brings together treatment explanations, needle phobia screening, TCM health history and legal consent into one seamless digital experience.

Instead of juggling paper clipboards, messy PDFs and email follow-ups, Paperform lets you create an on-brand, mobile-friendly form that patients can complete before their first visit. You can embed it on your website, share it via email or text, and automatically route submissions to your practice management software or patient records system.

Built for acupuncture and TCM practitioners

This template covers everything you need for a thorough first appointment:

• Treatment explanation and informed consent: Clear, plain-language descriptions of acupuncture, potential risks and benefits, helping patients understand what to expect.
• Needle phobia and anxiety assessment: Sensitive screening questions that identify patients who may need extra reassurance or modified treatment approaches.
• Traditional Chinese Medicine health intake: Questions about constitution, symptoms, lifestyle, diet and emotional health that inform TCM diagnosis and treatment planning.
• Medical history and current medications: Standard intake fields for conditions, allergies and medications to ensure safe, integrated care.

Conditional logic shows or hides follow-up questions based on patient responses, keeping the form concise for straightforward cases while gathering detailed information when needed. And because the form is digital, you can update treatment descriptions or add new questions as your practice evolves—no reprinting required.

Automate intake, consent tracking and appointment prep

Paperform's built-in workflow features help you stay organized and compliant:

• Papersign integration: Automatically generate a consent document from the patient's submission and send it for eSignature, creating a legally binding record that's linked to the original form.
• Stepper workflows: Route new patient submissions to your scheduling system, send a welcome email with pre-appointment instructions, log details in your CRM or practice management software, and notify your front desk—all automatically.
• Conditional notifications: Send different confirmation messages or care instructions based on whether a patient flagged needle anxiety, specific health concerns or other factors.

This automation reduces admin time, ensures nothing slips through the cracks, and lets you focus on delivering excellent patient care rather than chasing paperwork.

Professional, reassuring and on-brand

First impressions matter, especially for patients who may be nervous or unfamiliar with acupuncture. Paperform's doc-style editor lets you match the form to your clinic's branding, add calming imagery, embed educational videos and write in a warm, reassuring tone that puts patients at ease. Choose from a classic multi-page layout or Paperform's Guided Mode for a gentle, one-question-at-a-time experience that feels more like a conversation than a medical form.

Whether you're a solo practitioner, a multi-practitioner clinic, or part of an integrative health center, this template gives you a professional, HIPAA-alternative compliant foundation for acupuncture intake and consent. Trusted by healthcare providers worldwide, Paperform is SOC 2 Type II certified and designed for secure, patient-friendly data collection.

Start with this template, customize the questions and consent language to match your practice and local regulations, and transform your patient onboarding into a seamless digital experience.