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Request a consultation

Three short questions about your pain, then a number we can reach you on. It takes about a minute.

What happens next. Someone from the practice calls you back, asks what is going on and tells you whether this is something we treat. If it is not, we say so and point you somewhere else.

Calls go out Monday to Friday. If you would rather not wait for a callback, call (407) 440-2808 during those hours and ask for the next opening. Both ways end up in the same place.

Where can we reach you?

Two things are enough and you are done. Everything else can wait for the call.

Please tell us what to call you.

We call you back, so we need a number that works.

By sending this form you ask Acupuncture of Orlando to call you back at the number you gave us. Giving us your number does not by itself allow us to text you, so the two boxes below are separate and both optional.

Consent is not a condition of treatment or of any purchase. You can leave both boxes empty and still send this form, we will call you back either way. See our privacy notice and terms of service.

What hurts?

Pick all that apply, most patients arrive with more than one. If none of them fit, the last option is fine.

How long have you had it?
What have you already tried?

Pick all that apply. This is the part most people have the longest list for.