{"id":56,"date":"2011-05-29T00:00:37","date_gmt":"2011-05-29T00:00:37","guid":{"rendered":"http:\/\/www.urbanacupuncturecenter.org\/temp\/?page_id=56"},"modified":"2019-04-17T02:30:20","modified_gmt":"2019-04-17T02:30:20","slug":"online-forms","status":"publish","type":"page","link":"https:\/\/urbanacupuncturecenter.org\/newsite\/online-forms\/","title":{"rendered":"Forms"},"content":{"rendered":"<p>[et_pb_section bb_built=&#8221;1&#8243;][et_pb_row][et_pb_column type=&#8221;4_4&#8243;][et_pb_text admin_label=&#8221;Forms Text&#8221; _builder_version=&#8221;3.19.15&#8243;]<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignright size-full wp-image-1622\" src=\"http:\/\/urbanacupuncturecenter.org\/newsite\/wp-content\/uploads\/2018\/09\/UA_Sue.jpg\" alt=\"Sue Bowlus\" width=\"225\" height=\"290\" \/><\/p>\n<h1>Forms<\/h1>\n<p><a href=\"https:\/\/practisforms.com\/urbanacupuncturecenter\/forms\/new-patient-community-intake-form\" target=\"_blank\" rel=\"noopener\">New Patients &#8211; Community Acupuncture<\/a><\/p>\n<p><a href=\"https:\/\/practisforms.com\/urbanacupuncturecenter\/forms\/new-patient-private-intake-form\" target=\"_blank\" rel=\"noopener\">New Patients &#8211; Private Acupuncture<\/a><\/p>\n<p>Please take a few minutes to provide us with some information about your health history.\u00a0 For your convenience, all forms can be easily completed online without the need to print or fax. Just remember to click \u2018submit\u2019 at the bottom of the page and we will receive your information securely.\u00a0<\/p>\n<p>\u00a0<\/p>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n<p><span class='st_facebook' st_title='Forms' st_url='https:\/\/urbanacupuncturecenter.org\/newsite\/online-forms\/' displayText='facebook'><\/span><span class='st_twitter' st_title='Forms' st_url='https:\/\/urbanacupuncturecenter.org\/newsite\/online-forms\/' displayText='twitter'><\/span><span class='st_email' st_title='Forms' st_url='https:\/\/urbanacupuncturecenter.org\/newsite\/online-forms\/' displayText='email'><\/span><span class='st_sharethis' st_title='Forms' st_url='https:\/\/urbanacupuncturecenter.org\/newsite\/online-forms\/' displayText='sharethis'><\/span><span class='st_plusone' st_title='Forms' st_url='https:\/\/urbanacupuncturecenter.org\/newsite\/online-forms\/' displayText='plusone'><\/span><span class='st_pinterest' st_title='Forms' st_url='https:\/\/urbanacupuncturecenter.org\/newsite\/online-forms\/' displayText='pinterest'><\/span><\/p>","protected":false},"excerpt":{"rendered":"<p>[et_pb_section bb_built=&#8221;1&#8243;][et_pb_row][et_pb_column type=&#8221;4_4&#8243;][et_pb_text admin_label=&#8221;Forms Text&#8221; _builder_version=&#8221;3.19.15&#8243;] Forms New Patients &#8211; Community Acupuncture New Patients &#8211; Private Acupuncture Please take a few minutes to provide us with some information about your health history.\u00a0 For your convenience, all forms can be easily completed online without the need to print or fax. Just remember to click \u2018submit\u2019 at [&hellip;]<\/p>\n<p><span class='st_facebook' st_title='Forms' st_url='https:\/\/urbanacupuncturecenter.org\/newsite\/online-forms\/' displayText='facebook'><\/span><span class='st_twitter' st_title='Forms' st_url='https:\/\/urbanacupuncturecenter.org\/newsite\/online-forms\/' displayText='twitter'><\/span><span class='st_email' st_title='Forms' st_url='https:\/\/urbanacupuncturecenter.org\/newsite\/online-forms\/' displayText='email'><\/span><span class='st_sharethis' st_title='Forms' st_url='https:\/\/urbanacupuncturecenter.org\/newsite\/online-forms\/' displayText='sharethis'><\/span><span class='st_plusone' st_title='Forms' st_url='https:\/\/urbanacupuncturecenter.org\/newsite\/online-forms\/' displayText='plusone'><\/span><span class='st_pinterest' st_title='Forms' st_url='https:\/\/urbanacupuncturecenter.org\/newsite\/online-forms\/' displayText='pinterest'><\/span><\/p>","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"open","ping_status":"open","template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"<p>[frame_left src=\"http:\/\/www.urbanacupuncturecenter.org\/wp-content\/themes\/Accent\/images\/vert-pic-2.jpg\"] [\/frame_left]<\/p><p>Please read the welcome letter and then print and fill out our first visit intake form and financial policy.<br \/>Bring these with you to first visit.<\/p><p>Click to view\/download the PDFs:<\/p><p style=\"margin-top: 30px;\">\u2022 <a href=\"http:\/\/www.urbanacupuncturecenter.org\/wp-content\/uploads\/2011\/06\/uac-welcome-letter.pdf\" target=\"_blank\" rel=\"noopener\"><strong>Welcome letter<\/strong><\/a><\/p><p style=\"margin-top: 20px;\">\u2022 <a href=\"http:\/\/www.urbanacupuncturecenter.org\/wp-content\/uploads\/2014\/09\/uac-first-visit-intake-form.pdf\" target=\"_blank\" rel=\"noopener\"><strong>First visit intake forms for new patients<\/strong><\/a><\/p><p style=\"margin-top: 20px;\">\u2022 <a href=\"http:\/\/www.urbanacupuncturecenter.org\/wp-content\/uploads\/2013\/09\/APE-Bonus-HelpSheets.pdf\" target=\"_blank\" rel=\"noopener\"><strong>Patient Help Sheets, Acupressure points (12 page PDF)<\/strong><\/a><\/p><p style=\"margin-top: 20px;\">\u00a0<\/p>","_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"class_list":["post-56","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v24.2 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Forms - Urban Acupuncture Center<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/urbanacupuncturecenter.org\/newsite\/online-forms\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Forms - Urban Acupuncture Center\" \/>\n<meta property=\"og:description\" content=\"[et_pb_section bb_built=&#8221;1&#8243;][et_pb_row][et_pb_column type=&#8221;4_4&#8243;][et_pb_text admin_label=&#8221;Forms Text&#8221; _builder_version=&#8221;3.19.15&#8243;] Forms New Patients &#8211; Community Acupuncture New Patients &#8211; Private Acupuncture Please take a few minutes to provide us with some information about your health history.\u00a0 For your convenience, all forms can be easily completed online without the need to print or fax. Just remember to click \u2018submit\u2019 at [&hellip;]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/urbanacupuncturecenter.org\/newsite\/online-forms\/\" \/>\n<meta property=\"og:site_name\" content=\"Urban Acupuncture Center\" \/>\n<meta property=\"article:modified_time\" content=\"2019-04-17T02:30:20+00:00\" \/>\n<meta property=\"og:image\" content=\"http:\/\/urbanacupuncturecenter.org\/newsite\/wp-content\/uploads\/2018\/09\/UA_Sue.jpg\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/urbanacupuncturecenter.org\/newsite\/online-forms\/\",\"url\":\"https:\/\/urbanacupuncturecenter.org\/newsite\/online-forms\/\",\"name\":\"Forms - Urban Acupuncture Center\",\"isPartOf\":{\"@id\":\"https:\/\/urbanacupuncturecenter.org\/newsite\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/urbanacupuncturecenter.org\/newsite\/online-forms\/#primaryimage\"},\"image\":{\"@id\":\"https:\/\/urbanacupuncturecenter.org\/newsite\/online-forms\/#primaryimage\"},\"thumbnailUrl\":\"http:\/\/urbanacupuncturecenter.org\/newsite\/wp-content\/uploads\/2018\/09\/UA_Sue.jpg\",\"datePublished\":\"2011-05-29T00:00:37+00:00\",\"dateModified\":\"2019-04-17T02:30:20+00:00\",\"breadcrumb\":{\"@id\":\"https:\/\/urbanacupuncturecenter.org\/newsite\/online-forms\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/urbanacupuncturecenter.org\/newsite\/online-forms\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/urbanacupuncturecenter.org\/newsite\/online-forms\/#primaryimage\",\"url\":\"http:\/\/urbanacupuncturecenter.org\/newsite\/wp-content\/uploads\/2018\/09\/UA_Sue.jpg\",\"contentUrl\":\"http:\/\/urbanacupuncturecenter.org\/newsite\/wp-content\/uploads\/2018\/09\/UA_Sue.jpg\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/urbanacupuncturecenter.org\/newsite\/online-forms\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/urbanacupuncturecenter.org\/newsite\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Forms\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/urbanacupuncturecenter.org\/newsite\/#website\",\"url\":\"https:\/\/urbanacupuncturecenter.org\/newsite\/\",\"name\":\"Urban Acupuncture Center\",\"description\":\"Ohio&#039;s 1st Community Acupuncture Clinic\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/urbanacupuncturecenter.org\/newsite\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Forms - Urban Acupuncture Center","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/urbanacupuncturecenter.org\/newsite\/online-forms\/","og_locale":"en_US","og_type":"article","og_title":"Forms - Urban Acupuncture Center","og_description":"[et_pb_section bb_built=&#8221;1&#8243;][et_pb_row][et_pb_column type=&#8221;4_4&#8243;][et_pb_text admin_label=&#8221;Forms Text&#8221; _builder_version=&#8221;3.19.15&#8243;] Forms New Patients &#8211; Community Acupuncture New Patients &#8211; Private Acupuncture Please take a few minutes to provide us with some information about your health history.\u00a0 For your convenience, all forms can be easily completed online without the need to print or fax. Just remember to click \u2018submit\u2019 at [&hellip;]","og_url":"https:\/\/urbanacupuncturecenter.org\/newsite\/online-forms\/","og_site_name":"Urban Acupuncture Center","article_modified_time":"2019-04-17T02:30:20+00:00","og_image":[{"url":"http:\/\/urbanacupuncturecenter.org\/newsite\/wp-content\/uploads\/2018\/09\/UA_Sue.jpg","type":"","width":"","height":""}],"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/urbanacupuncturecenter.org\/newsite\/online-forms\/","url":"https:\/\/urbanacupuncturecenter.org\/newsite\/online-forms\/","name":"Forms - Urban Acupuncture Center","isPartOf":{"@id":"https:\/\/urbanacupuncturecenter.org\/newsite\/#website"},"primaryImageOfPage":{"@id":"https:\/\/urbanacupuncturecenter.org\/newsite\/online-forms\/#primaryimage"},"image":{"@id":"https:\/\/urbanacupuncturecenter.org\/newsite\/online-forms\/#primaryimage"},"thumbnailUrl":"http:\/\/urbanacupuncturecenter.org\/newsite\/wp-content\/uploads\/2018\/09\/UA_Sue.jpg","datePublished":"2011-05-29T00:00:37+00:00","dateModified":"2019-04-17T02:30:20+00:00","breadcrumb":{"@id":"https:\/\/urbanacupuncturecenter.org\/newsite\/online-forms\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/urbanacupuncturecenter.org\/newsite\/online-forms\/"]}]},{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/urbanacupuncturecenter.org\/newsite\/online-forms\/#primaryimage","url":"http:\/\/urbanacupuncturecenter.org\/newsite\/wp-content\/uploads\/2018\/09\/UA_Sue.jpg","contentUrl":"http:\/\/urbanacupuncturecenter.org\/newsite\/wp-content\/uploads\/2018\/09\/UA_Sue.jpg"},{"@type":"BreadcrumbList","@id":"https:\/\/urbanacupuncturecenter.org\/newsite\/online-forms\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/urbanacupuncturecenter.org\/newsite\/"},{"@type":"ListItem","position":2,"name":"Forms"}]},{"@type":"WebSite","@id":"https:\/\/urbanacupuncturecenter.org\/newsite\/#website","url":"https:\/\/urbanacupuncturecenter.org\/newsite\/","name":"Urban Acupuncture Center","description":"Ohio&#039;s 1st Community Acupuncture Clinic","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/urbanacupuncturecenter.org\/newsite\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"}]}},"_links":{"self":[{"href":"https:\/\/urbanacupuncturecenter.org\/newsite\/wp-json\/wp\/v2\/pages\/56","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/urbanacupuncturecenter.org\/newsite\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/urbanacupuncturecenter.org\/newsite\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/urbanacupuncturecenter.org\/newsite\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/urbanacupuncturecenter.org\/newsite\/wp-json\/wp\/v2\/comments?post=56"}],"version-history":[{"count":6,"href":"https:\/\/urbanacupuncturecenter.org\/newsite\/wp-json\/wp\/v2\/pages\/56\/revisions"}],"predecessor-version":[{"id":2283,"href":"https:\/\/urbanacupuncturecenter.org\/newsite\/wp-json\/wp\/v2\/pages\/56\/revisions\/2283"}],"wp:attachment":[{"href":"https:\/\/urbanacupuncturecenter.org\/newsite\/wp-json\/wp\/v2\/media?parent=56"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}