acupuncture clinic & oriental medicine




Patient Forms



Save time by downloading your initial patient intake form at home and bring it prior to your first visit!

  • Please complete these documents as thoroughly as possible.
  • Some of the conditions may seem unrelated to your condition, however they could play a significant role in the diagnosis and treatment.
  • All information is strictly confidential.
  • Insurance patients: Please confirm you have active acupuncture coverage prior to first visit.

Click Here to download Intake Forms

Click Here to download LIFE COACH Forms

Healing Oak Acupuncture Clinic

Randall Wegener, L.Ac., Dipl. Ac., MSTOM, HAPM

593 E. Elder St. Suite A
Fallbrook, CA 92028