New Patient Form Name(Required) First Last Email(Required) Phone(Required)What treatments are you interested in receiving?(Required) Alchemy Acupressure Five Element Consultation Ling-Shu Treatment (such as Ghost Points) Alchemical Life Strategy Coaching Reiki Massage Craniosacral I would prefer to see… No Preference Leta Herman (Alchemy and Acupressure) Jaye McElroy (Alchemical Life Strategy Coaching) Raili Raud (Acupuncture, Herbal Medicine and Alchemy) Penny Herter (Alchemy and Reiki) Ana Bennett (Craniosacral) Do you prefer an in-person treatment or telemedicine?(Required) In-person at our Northampton, Massachusetts clinic A virtual (telemedicine) appointment Any additional details you would like to share about the reason for your visit.How did you hear about us?Please contact me by: Text Phone Call Email PhoneThis field is for validation purposes and should be left unchanged. Δ
