760-634-9715

CAP Wellness Center Forms

Here are all of the forms that you may need to access for services at the CAP Wellness Center. Please download the one you need for your visits, print and fill them out and then bring them with you to your appointment.

Acupuncture

New Patient Health History Form -Adult (same form for both Acupuncture and Chiropractic)

Acupuncture Informed Consent Form

Women’s Fertility Symptom Survey

New Patient Payment Policy Form

Chiropractic

New Patient Health History Form – Adult (same form for both Acupuncture and Chiropractic)

Chiropractic Informed Consent Form – Adult

Infant/Child Health History Form (Informed Consent included)

New Patient Payment Policy Form

Massage

Massage Therapy Client Intake Form

Lactation Consultation

Lactation Consultation Form

Yoga

Yoga Waiver/Consent Form

If you have any questions, please call the CAP Wellness Center at (760) 634-9715.

Location

535 Encinitas Blvd, Suite 115
Encinitas, CA 92024

Contact

(760) 634-9715
[email protected]

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