Acupuncture Appointment with Michael Rossoff, L.Ac.
What to Bring to the Initial Evaluation
• Personal History Form (below) filled in with your
information then email it ahead to me
• Recent medical tests, if easily available
(these might be blood tests or summary reports from
more extensive tests like MRI or CAT/CT scan)
• Read certain important do’s and don'ts (below)
• Your first treatment immediately follows the initial evaluation,
so expect the first visit to last 1½-2 hours
• A relaxed mind and body, so that you can experience the
benefits all the sooner
Personal History Form
The Personal History Form (3 pages) can be filled out online and returned to me.
• Download the form with the links below.
• Then open it using Adobe Acrobat Reader, which is already on most computers, otherwise there is a free copy HERE (be sure to uncheck all "Included with your download" before clicking Download).
• When you're finished filling out the 3 pages in Adobe Reader...
• Download (Save) your filled-in version to your computer, renaming it "Your Name -- Personal History Form"
• Attach this to an email that you will send to me (firstname.lastname@example.org). Please put "Your Name -- Personal History Form" in the Subject line.
I look forward to meeting you!
Special Instructions Regarding COVID-19
I am open for in-person counseling & acupuncture in my home office.
I am committed to protecting the health and safety of my clients while providing the highest quality of care.
** Your must be vaccinated in order to come in the office. **
• I will provide a safe and clean environment by thoroughly disinfecting the treatment room and sanitizing all public surfaces.
• I am spreading out appointments to allow ample time to sanitize treatment rooms between patients.
• You must cancel your appointment if you are displaying cold or flu-like symptoms such as cough, fever, sore throat, shortness of breath, or new loss of smell or taste.
• You must wear a face mask, unless we agree otherwise.
• No one may accompany you to your appointment without prior permission.
• I will be wearing face mask, too.
• I have installed an air purifier in the treatment room to maintain ample air circulation and ventilation. Plus, the treatment room will be aired out after each treatment.
Directions to Your Appointment in Asheville, N.C.