We want to make sure your visit is as comfortable as possible.

New Patient Information

Things to know before your visit

  • Wear comfortable clothing.
  • Don’t eat a heavy meal before treatments or too light of one.
  • If you feel discomfort at any time, let your practitioner know.
  • Be sure that your practitioner has your complete history and update your practitioner with any changes in history.
  • If it’s your first time at Affinity Acupuncture, please arrive at least 15 minutes early to complete the necessary forms. Otherwise, arrive 5 minutes early so you can have a few minutes to rest and relax before your treatment.
  • Any minors (age 17 and under) must have written consent from a parent or guardian to receive any services.

Intake Forms

New Client Intake Forms

Welcome! We look forward to meeting you at your upcoming visit. Please print and complete the appropriate form listed below and bring it with you to your visit. Please contact us at 615-939-2787 if you cannot open the form.

For your convenience, fill out our intake forms before your first appointment. Before your private acupuncture, our practitioners will go over the forms with you to customize a treatment to best help you relieve pain, achieve fertility, reduce stress, and improve your health in many other areas as well.

Please read and complete each of the below forms for ACUPUNCTURE:
New Client Acupuncture Intake Form

Medical Insurance Options

We accept Blue Cross Blue Shield and United Healthcare. For your convenience, we can verify your insurance benefits before you arrive for your initial consultation. 

Our Policies

In order to keep costs down and scheduling running smoothly, Affinity Acupuncture asks for our clients to abide by our arrival and 24-hour cancellation policies.

Cancellation Policy

We require a 24 hour notification of cancellation or rescheduling of any appointment. Failure to provide proper notification will result in a service charge on your credit card.

Late Arrival Policy

Our clients are often pleased that we are usually on time. The treatment room has been reserved for you for a specific length of time. Occasionally, things come up and our patients are tardy. When that occurs, appointment length must be shortened accordingly so we may stay on schedule. Please call to notify us if you are running late. We will do our best to accommodate, but reserve the right to consider it a “missed” or “no show” appointment and charge you for the session if you are more than 30 minutes late.

Please attempt to arrive 10 minutes before your scheduled appointment to ensure you receive the full time allotted to you.

Inclement Weather Policy

In the case of inclement weather, Affinity Acupuncture will be closed if Williamson County and Davidson County Schools are closed. Our focus is to restore you to optimal health, and we do not encourage travel if weather causes dangerous travel conditions.


Comfort & Safety

Your comfort and safety are one of our top priorities. We are taking steps to make sure our environment is as safe as possible, especially during the COVID-19 pandemic. Masks are required for practitioners and clients, and clients are screened before entering the treatment area. We frequently clean and disinfect our space with surface cleaners as well as UV light and air purifiers, and ask that if you are sick or have been exposed to anyone with COVID-19 to please wait 14 days before your next scheduled visit.