New Patient

Forms

Please print and fill out the following forms before the appointment. If you do not have an access to a printer, these forms are available at the clinic too.  If you plan to fill them out at our clinic, please arrive early.

Note: Our practice requires that you sign an arbitration form, which is available at our clinic, before your initial treatment.

Privacy Policy

Your privacy is protected by Health Insurance Portability and Accountability Act (HIPPA), and it basically prohibits us from discussing your case with anyone without your authorization.  Your privacy is very important to us, and our privacy policy is provided below:

Reminders

  • Please wear comfortable and loose fitting clothing for your appointment.  A treatment session typically last for 40-60 minutes.
  • Please make sure to eat something before your appointment.
  • Please do not brush your tongue on the day of your appointment. Your tongue coating is used as a vital part of our diagnosis.
  • Please turn off your cell phone before entering the clinic and avoid wearing cologne, perfume, or strongly scented lotion on the day of your appointment in order to respect other clients receiving treatment.
  • Please remove your shoes and change to slippers (provided) at the door as we often need to have an access to your feet for the treatment.
  • If you are going to be late or need to cancel an appointment, please give us a call at (512) 656-3060.

We are looking forward to seeing you soon.


If you have any questions or comments, please send it to tomoya@akashiacu.com