New Patient: Preparing For Your First Visit

Welcome!

We’re happy that you chose us to help with your acupuncture and chiropractic needs!
Listed below are some forms to fill out and information that will help you to be
better prepared for your first visit with Dr. Rubcich.

Forms
 

Please fill out and sign the forms linked below and bring them with you to your visit

Important Information
 

Please arrive at least 10 minutes before your appointment

Payments in the form of cash or check are collected at the time services are
 rendered. No credit cards are accepted

We will gladly check to verify whether your insurance policy provides coverage
 for acupuncture services.

Be sure to wear loose fitting and comfortable clothing to your appointment

 If you should have any questions, feel free to discuss them with the staff or with the
 practitioner. Feel free to call us at (856) 228-1330

Four Gates Acupuncture

805 S. Black Horse Pike

Blackwood, NJ 08012

Acupuncture is safe, drug-free, and effective!

© 2017 by Four Gates Acupuncture.