New Patients

Welcome to Goleta Acupuncture Wellness Clinic. If you are new to our Clinic, please print and fill out the form below and bring it with you to your first appointment.

For your information, you may review the Privacy Practice Policy below:


In an effort to better serve you, the following suggestions are provided to help you have a safe and relaxing experience with acupuncture:

  • Allow approximately 75 – 90 minutes for your first visit and 75 minutes for subsequent visits.
  • Payments are expected at the time services are rendered.
  • Please bring any lab or medical reports relevant to your conditions.
  • Wear loose, comfortable clothing.
  • Avoid coming to your appointment with empty stomach. You can have a light meal or a snack half hour to an hour prior to your visit.
  • Avoid alcohol on the day of your treatment.
  • Do not hesitate to discuss any questions you might have with us during your intake.

Thank you and I look forward to meeting with you!

Call (805) 895-5507 for an appointment today.

5266 Hollister Ave
Suite 204
Santa Barbara, CA 93111