For a Skype or Telephone Consultation Click HERE.

Forms for Counseling or Acupuncture

Call: 828-258-1883
Fax: 206-600-6218
Email: michael@michaelrossoff.com
To discuss • Scheduling an appointment • Cost for the consultation • Location for the appointment

       For Personal Counseling       

What to Bring to the Consultation
• Filled-out the Personal History Form (below)
• Read Important Pre-Consultation Info (below)
• Bring Medical Reports (only most important)
• Write Questions (on a separate paper) that you want to be sure get answered

     For Acupuncture Treatments     

What to Bring to the Initial Evaluation
• Filled-out Personal History Form Only (below)
• See the bottom of the Acupuncture Practice page for certain important do’s and don’ts
• Your first treatment immediately follows the initial evaluation

Personal History Form
These forms must be filled out in advance. Please download the appropriate form with the links below. Then open it on your computer, print it out, and then fill it out (in black ink).
Please be aware that the use of these forms are specific to my healing work. Other counselors or acupuncturists will use their own form. Please do not need to mail or send it on to me in advance of our appointment unless we are doing a telephone or Skype session. I prefer that you bring it with you to the initial meeting.
I look forward to meeting you!
Personal History Form       
     (3 pages, in pdf format)        
Follow-Up (Revisit) Form
(1 page, in pdf format)
(Bring your “Nutritional Guidance Booklet” to the Follow-Up session)
          Important
      Pre-Consultation
         Information

Directions to Appointments in London, England