New Patient Information

Please be sure to thoroughly read all information on this page.


Hello, I look forward to meeting with you!  

In order for your treatment to be streamlined so that all of our time is spent on your treatment, please make sure to download the below paperwork.

More details....

  • Please be sure to click, download and fill out the Health History Form, Waiver, and General Questionnaire and bring it with you already completed to your appointment. If you are coming for Fertility Support, please fill out the Fertility Form.
    • If for some reason you don't think you will be able to complete the forms, you may come 15 minutes early to your treatment to do so.
  • Please read the Acupuncture Welcome Letter at least 1 day before your treatment so you know how to best be prepared and make the most out of your treatment.

 

Downloads:

Health History FORM

Waiver

Acupuncture Welcome Letter

General questionnaire

FERTILITY FORM


 

Policies

 

Cancellation:  

If there is a non-emergency cancellation in less than 24 hours of an appointment, an $85 Late Cancellation fee will be billed to that account.

PLEASE TAKE NOTE:  We are unable to administer a treatment if you are more than 15 minutes late for your appointment, and the account will be billed as a Late Cancellation for $85 .

 

No Shows:  

We bill all no-show accounts $85 due immediately. 


Locations

 

We are located at:

Rittenhouse Square Medical Tower

110 S. 20th St. #202

Philadelphia, PA 19103

 

Please get in touch with us if you have any questions: 

P: (267) 713-9496

E: restorativeharmony@gmail.com