Book an appointment with Silver Pines Acupuncture  using SetMore

Patients

Please download and print out the appropriate paperwork, so that you may have a chance to complete it or come up with questions before you come in. If a printer is unavailable to you, then feel free to ask for a printed copy. I also accept 

Only patients seeking herbs must fill out the detail herb patient paperwork. 

New Patient Paperwork 

Please fill out and sign all that you can before you come in. It's ok to wait to sign documents if you would like to ask a question first. 

Download Now

NOTICE OF PRIVACY PRACTICES

Notice of Privacy Practices from the HIPAA Consent Form located in the new patient paperwork. 

Download Now

Granular Herb Cooking Instructions 

Click the link below for granular herb cooking instructions. If you need to know your dosage, then please contact me. 

Download Now

Food Based Tea Recipe

The following is a recipe for a basic food based tea to help support a healthy digestive system and immune system. This tea is not to treat or cure any disease or symptoms.

Download Now

Ginger Compress/Bath

Instructions on how to prepare your own ginger compress/bath. 

Download Now

Stick On Moxa home Guide

My teacher and friend, Heather Maya Suzuki, made a lovely video about stick on moxibustion. If you have more questions, or would like a personal demonstration, then please reach out to Maya or myself. 

View Now

Digital Security 

Learn what you can do to make yourself more digitally secure. 

Download Now

Practitioners 

I've put a lot of hard work and time into manifesting my dream of being of service to others. I want to share my work with other practitioners, so they can better serve their patients. 

New Patient Paperwork

This is my new patient paperwork without my name and practice on each page. 

Download Now

Herb Patient Paperwork

This is my herb patient paperwork without my name and practice on each page.

Download Now

NOTICE OF PRIVACY PRACTICES

This is my notice of privacy practices without my name and practice on each page.

Download Now

Symptoms Checklist

This is my symptoms checklist without my name and practice on each page.

Download Now

Treatment Form

This is my treatment form without my name and practice on each page. 

Download Now

Herbal pricing Sheet

Here's the spread sheet I use to accurately price herbs for a patient. I use the find feature to find the herb or formula I want. I then add the number of grams I want of granular herbs or bulk. If you want to prescribe a capsule bottle of a formula, then use the "bulk" column. Put a 1 in the place value. As long as you have a price that bottle entered, then it'll work. I am leaving prices empty to indicate that I don't have that product stocked. Once I have entered all the grams into the herbs you want, then I use the sorting feature to show only the herbs in the formula. I then copy all the relevant info into my herbal treatment form. Email me if you have any questions. 

Download Now

Herbal Treatment Form

This is my herbal treatment form without my name and practice on each page. I write up my herbal treatment forms separately from my regular treatment form in order to share it with apothecary staff without disclosing any information other than the patient's name and contact. 

Download Now

Granular Herb Cooking Instructions

This is my granular herb cooking instructions without my name and practice on each page.

Download Now

Bulk Herb Cooking Instructions

This is my bulk herb cooking instructions without my name and practice on each page.

Download Now

Food Based Tea Recipe

This is my food based tea cooking instructions without my name and practice on each page.

Download Now

Ginger Compress/Bath

This is my ginger compress/bath instructions without my name and practice on each page.

Download Now

Flash Cards

I used Quizlet to take notes and to study for all my classes at SWAC and for my board exams. I have arranged study sets of flash cards into classes. If you have any questions on how to use Quizlet, or for how I used it for school, then please contact me. 

Visit Classes

S.P.A.