Bend Community Acupuncture
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    • Events
  • Who we help
    • What Can Acupuncture Treat?
    • Women's Health >
      • Preconception
      • Female Fertility >
        • Acupuncture for Miscarriage
      • Pregnancy & Labor >
        • Heartburn
        • Morning Sickness
      • Postpartum
      • Menopause
      • Acupressure
      • Diet
    • Men's Health >
      • Acupuncture For Male Fertility
    • Pain & Injuries
  • About
    • Rob Mills, L.Ac.
    • Emden Griffin, L.Ac.
  • Blog
  • New Patients
    • New Patient Forms
    • Services
    • Payment Options >
      • Sliding Scale Information
      • Insurance Billing
    • Directions & Hours
    • What to Expect
    • Resources >
      • What is Kiiko Matsumoto Style acupuncture?
      • What is Oriental Medicine?
      • What Can Acupuncture Treat?
      • The Importance of Diet
      • Resources & Links
  • Contact Us
    • Contact & Scheduling

New Patient Forms

Save time on your first visit!  
  • Click on ONE of the links below​ to access the new patient paperwork
    • New Patient Forms (sliding scale)
      • ​​COVID-19 Informed Consent Form
    • New Patient Forms (insurance billing)
      • ​​Insurance Verification Form
      • COVID-19 Informed Consent Form
  • Print all 6 pages of the document
  • Fill out all of the forms as accurately & completely as possible
  • Bring them with you to your first appointment
  • ​Bring your insurance card with you

If you are unable to access or print the forms:
  • Please arrive at least 20 minutes early to fill out the paperwork in the office. Thank you!​
WHAT TO EXPECT AT YOUR FIRST VISIT

Location

Bend Community Acupuncture
911 NE 4th St, Ste 2
Bend, OR 97701

What Our patients Are Saying

I feel extrememly fortunate to have found Rob and Emden! Both are practioners with great knowledge of Eastern Medicine/Acupuncture and know how to meet and offer support for the individual who seeks their care. I feel comforted just entering the waiting room and great ease and respite as I am listened to and met as I share my concerns. I always leave my treatment more knowledgeable about how I can meet my pain/sickness and more relaxed because I allowed myself to be cared for."
-Ida C. Bend, OR

Contact Us

Submit
Phone: 541-388-4999
Fax: 512-493-6178
  • Home
    • For Providers
    • Events
  • Who we help
    • What Can Acupuncture Treat?
    • Women's Health >
      • Preconception
      • Female Fertility >
        • Acupuncture for Miscarriage
      • Pregnancy & Labor >
        • Heartburn
        • Morning Sickness
      • Postpartum
      • Menopause
      • Acupressure
      • Diet
    • Men's Health >
      • Acupuncture For Male Fertility
    • Pain & Injuries
  • About
    • Rob Mills, L.Ac.
    • Emden Griffin, L.Ac.
  • Blog
  • New Patients
    • New Patient Forms
    • Services
    • Payment Options >
      • Sliding Scale Information
      • Insurance Billing
    • Directions & Hours
    • What to Expect
    • Resources >
      • What is Kiiko Matsumoto Style acupuncture?
      • What is Oriental Medicine?
      • What Can Acupuncture Treat?
      • The Importance of Diet
      • Resources & Links
  • Contact Us
    • Contact & Scheduling