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New Patient Forms & HIPAA

New Patient Intake Form - To provide you with the best treatment possible, it's important for us to get to know your medical history and health goals.
*Please TEXT the completed document to (203)451-9865 IN ADVANCE or bring the completed forms to your first visit. Thank you.

Notice of Privacy Practices (HIPAA) - This notice is for your records. You don't have to bring it with you. This document describes your rights as a patient, how your medical information may be used, disclosed during your treatment, and how you can get access to your own records. We do not sell, share, distribute, rent, or profit from your confidential info.

Our Office Policies

Lateness is considered 15 mins after the appt time

Your appointment time is reserved exclusively for you. Pls let us know in advance if you cannot make your appointment so that we may offer that time to another patient. We appreciate a text if you are running 5-10 mins late. 

Missed Appointment
We Request 48 Hours Notice to Cancel or Reschedule 

It is the Patient’s responsibility to cancel or reschedule appointments. We do not guarantee appointment reminders. We respect your time at our clinic and reserve it just for you, so please respect our time and communicate with us in advance. You can text, email, or call us (203)451-9865 EST. 

We Charge for Missed Appointments

We charge a single session rate of $180/hr for a missed appointment, even if you are an “insurance patient who only pays a co-pay” and do not normally pay for treatments out-of-pocket. We uphold this policy for new and returning patients. Thank you.

Katherine Kim
Acupuncture Arts

212 Post Road West
Westport, CT 06880 USA
1+203)451-9865 EST
Questions? Call or Text
By appointment