Meridian Health Clinic
Acupuncture & Herbal Medicine
Eric Schmidt, L.Ac., Licensed Acupuncturist
Santa Monica, CA
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Intake Forms:
 
Before your first visit, please print out these forms (PDF Documents) and fill them out completely. Bring them with you on your first appointment. 
 
The first form covers basic legal matters such as giving consent for treatment:

The second form covers health history and your current health concerns:
 

* Some health insurance plans cover partial cost of acupuncture treatment.  Please read this page on insurance coverage and call your health insurance provider before your first office visit.