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Pacific Bay Integrative Health Center
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Forms

I.V. intake forms

Medical information statement

Information sheet and informed consent for IV hydration

Informed consent for IV

Consent for service and Demographic info

Acupuncture intake forms

Informed Consent Acupuncture – California

New Patient Form

Review of Systems Intake Form

Therapy intake forms

Fee Policy-Agreement 

Gen Info Question 

HIPAA Consent for Treatment 

 Telehealth Consent 

Pacific Bay Integrative Health Center
2901 Ocean Park Blvd., Suite #126
Santa Monica, CA   90405
Phone (310) 399-4043

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