Janne Irlandes    

Acupuncture & Massage Therapy Services

Janne Irlandes Acupressure or Acupuncture Intake Form

New Patient General Information

Please complete this form and be honest with yourself. Some of the questions that follow may seem unrelated to your condition, BUT they may play a major role in diagnosis and treatment. All information is strictly confidential. Just click “SUBMIT” at the bottom of the page and we will receive your information securely. Please note I am NOT able to accommodate walk in appointments and you do not have any until you receive confirmation from me. 
Thank you for contacting me. I will get back to you as soon as possible.
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