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Mountain Spirit Acupuncture Patient Forms

To save time prior to your visit to Mountain Spirit Acupuncture, please complete the forms below and bring them in for your initial treatment.

General Intake

Specialty Addendum

Initial Acupuncture Treatment

In this section you will find information on your role in the healing process. Please read each section carefully and then download and complete the patient forms. Please bring the forms to your initial acupuncture treatment.

Mountain Spirit Acupuncture believes strongly in educating clients and equipping them with the tools to sustain their health independently whenever possible. The more you become involved with your health and responsible for your body, the better you will feel.

Spend some time thinking about what you would like to achieve from your acupuncture treatment. What are your expectations? What questions or concerns do you have about acupuncture? Jot down a few notes to bring with you to your initial visit. The more openly we can communicate, the better we can help you and the more benefit you will receive.

Be realistic. If you have several conditions or symptoms you would like to address, please rank them. On your initial visit to the clinic, I will ask you primarily about your chief complaint. Secondary issues will also be noted and addressed as treatment progresses. Start noticing how you feel each day and make a few notes. With respect to your chief complaint, try to answer these questions:

Be as descriptive and specific as possible. For example, "pain" and "discomfort" are very general words. Oriental medicine recognizes subtle distinctions in different types of pain. Burning pain is not the same as pain that has a stabbing sensation. Listed below are some words you might use to distinguish your particular pain.

  • Sharp
  • Dull and achy
  • Constant
  • Burning
  • Contracting/Tight
  • Heavy
  • Radiating (from where?)
  • Intermittent
  • Stabbing
  • Distending
  • Numb
  • Pins & needles
  • No feeling
  • Wandering
  • Pounding

If none of these are appropriate, try coming up with your own words. If you are having difficulty describing your pain in words, try visualizing it or drawing a picture, and then describe what you see.

For your first visit, we have assembled a quick overview on what will happen prior to your acupuncture treatment, during, and what to expect after. We invite you to learn more about each.

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Spend some time preparing and thinking about what you would like to achieve from your acupuncture treatment. Take note of what you would like to work on.

Bring your notes

Bring your notes and a list of current medications.

Eat a light meal

Acupuncture is not performed on individuals who are fasting. Being over-hungry increases the risk of nausea or dizziness. At the same time, please do not overeat or eat any foods that cause your stomach to be upset (for example, rich, greasy, fried, or extremely spicy foods).

Drink water

Bodies that are well hydrated tend to respond better to acupuncture.

Avoid alcohol

Acupuncture is not performed on intoxicated individuals due to the increased risk of shock. It is also not advisable to become intoxicated shortly after your acupuncture treatment.

Avoid heavy exertion

Set aside enough time so that you are not rushing to and from your treatment. Physical strain immediately before or after acupuncture can weaken your body. Please schedule your activities on the day of your visit accordingly (for example, do not schedule your appointment for an hour before your 2 hour kickboxing class).

Wear loose, comfortable clothing

Acupuncture points are located all over the body. Many of the acupuncture points that are commonly used are located between the wrists and elbows, and the ankles and knees. You will be more comfortable if your clothing can be easily rolled up to your elbows and knees. Women should not wear one-piece dresses. If necessary, a gown can be provided.

Be on time

Be on time for your appointment so that you may benefit fully. When you make an appointment, please understand that time has been reserved for you. There will be a charge for missed appointments without 24 hours' notice.


At Mountain Spirit Acupuncture, treatments are individualized to promote wellness and wholeness in all phases of patients' lives.

Initial examination

Your first acupuncture treatment will begin with an in-depth assessment of your condition and an initial treatment. The intake and treatment may take up to 2 hours. Typical follow-up treatments last approximately 60 minutes.

During the assessment

We may ask you about some things that you might not think are connected to your chief complaint, for example, your emotions, sleeping patterns, and eating habits. Oriental medicine considers the whole person, not just one isolated symptom. When put together, the myriad of symptoms and signs you are experiencing reveal patterns of disharmony. Although treatment will focus on your chief complaint, your whole being must be considered in order to develop the most appropriate course of treatment. Chinese medicine is unique in that it appreciates that illnesses may be identical, but the persons suffering from them are unique.

Pulse and Tongue diagnosis

As part of your intake, viewing your tongue and feeling your pulse can provide a practitioner of the Oriental Medical Arts with a great deal of information about your body to help guide the treatment. We choose to feel both the wrist and neck pulses to further focus our treatment goals.

Following the diagnostic assessment

Our patients may experience treatment in one or more of the following modalities:



Our expectation is that patients will feel better each time they receive a treatment. Feeling better might include relief of physical pain, a sense of being more balanced, or a reduction of stress and an increase of relaxation. Please drink lots of water after each treatment in order to flush out the toxins that tend to be released from the body after acupuncture.

Side Effects

Side effects are rare but may include the following symptoms: light-headed feeling, headaches, dizziness, sleepiness, euphoria, nausea, slight bruising, and residual muscle aching. Any of these should last a very short time. It is helpful to take a short nap after acupuncture. To help reduce the risk of side effects, please read the sections entitled Before and  During.

Flare Ups

On rare occasions one's original symptoms may briefly get worse or 'flare-up' after a treatment. A flare-up typically occurs later on the day of your treatment and only for an hour or so; then improvement and relief follow. If the flare-up lasts longer than this, please call and let us know. In the long run, acupuncture does not make symptoms worse. In some conditions, the body must fully expel a pathogen in order for healing to occur. For example, if you have a cold, acupuncture will not get rid of the cold, but can help accelerate the cold cycle so your body gets healthy sooner. If you are fatigued and starting to get a cold, acupuncture may help your body ward it off. There are also some terrific herbal formulas for this. In cases of chronic pain, your original pain may improve and then unmask other less obvious pain in the surrounding area. Please report what happened when you return so we can modify your treatment accordingly. We will also be interested in any change in your use of painkiller medications as a result of treatment. Please be advised that changes in prescription medication require prior approval and strict monitoring by your family physician.

Course of Treatment

As part of your first visit, we will discuss with you a proposed course of treatment. Since individuals vary, it is difficult to state definitively at the time of your first visit how many treatments will be required. In general, acute conditions of recent onset may only require 2 or 3 treatments. Chronic conditions usually require more treatments to achieve sustained results. With chronic conditions we usually recommend an initial course of 3 to 5 treatments in order to make a better assessment of whether or not acupuncture will help the condition. Most people begin to experience results within the first 2 treatments. If there has been no response to the acupuncture after 4 to 6 treatments, acupuncture will likely not work and other approaches should be considered.