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Consultation Form

The community clinic is very busy, but also a very calm space. To help with time management it would be really helpful if you could fill in the online consultation form before you attend your appointment. Please share as much information as possible as  this is essential for diagnosis and treatment, while allowing more time to discuss your health. It also means you benefit from a longer treatment. 

The FIRST 10 QUESTIONS ARE COMPULSORY,  while additional questions are optional they aid diagnosis and treatment 

*Acupuncture is a safe method of treatment, but on extremely rare occasions, it may induce minor bleeding, bruising, numbness, or tingling near the needling sites, dizziness, and fainting, these rare side effects do not impose any risks or danger to a patient’s health or life.

Please contact Health Tree Acupuncture acupuncturist John if you have any questions or concerns  you may have before your first treatment.

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Consultation Form
Are your symptoms affecting?
Do you have any of the following?
Do you experience any of the following (regulary or occaisonally)?
Muscle/Joints/Bones
Sleep
Skin
Urinay/Bowels/Digestion
Cardiovascular
Gynaecology
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