6892 B Soquel Avenue, Santa Cruz, CA

phone: 831.818.7051

Live Oak Acupuncture & Healing Arts

Marcia Connelly LAc., Dipl. OM

Resources

Pregnancy Information • Claudia Citkovitz

Pregnancy and Fertility • Debra Betts

Acupressure • Debra Betts


Forms

Choose the appropriate link below and  do a “save as” to your computer where you can find it. “Right click on a PC” or “control click” on a mac in order to download the pdf file to your computer. This step is necessary to be successful. If you fill out the form in your browser, the submit button won’t work. 

General Intake Form

Women’s Health Assessment

Men’s Health Assessment

Pediatrics Form

Directions for submitting the intake forms

  1. If you don’t have acrobat reader, follow this link to download it to your computer.
  2. If you have a printer, feel free to complete the form, print it out and bring it with you.
  3. Once the form is on your computer, fill it out completely and click the submit button at the bottom. It will open a window with directions to email the file with whatever email method you use.
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