153 Acupuncture & Herbs Healing Center offers our patient form(s) online so that they can be completed in the convenience of your own home or office.

  • Download and print the necessary form(s), and fill in the required information.  If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Fax us your completed form(s) or bring them with you to your appointment.

NEW PATIENT HEALTH HISTORY FORM - REQUIRED

This allows us to know your past medical history as well as your current health state. Do you have any concerns or questions regarding acupuncture? Please let us know on this form as we would like to help you!

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NEW PATIENT QUESTIONNAIRE FORM - REQUIRED

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MEMBER WELLNESS REGISTRATION FORM - OPTIONAL

This form allows you to gain access to the Member Wellness section of our website. You can also sign up for our monthly newsletter to stay informed on current health issues and any events occurring at our clinic. You can print this form and bring it to your appointment or Click Here to register online. We look forward to making your experience with our clinic and website more interactive and rewarding!

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Contact

153 Acupuncture & Herbs Healing Center
2011 Lomita Blvd
Lomita, CA 90717
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  • Phone: 310-326-8250
  • Fax: 310-326-8132
  • Email Us

Office Hours

DayMorningAfternoon
MondayClosedClosed
Tuesday10am6:30pm
Wednesday10am6:30pm
Thursday10am6:30pm
Friday10am6:30pm
Saturday10am1:30pm
SundayClosedClosed

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