Darlene Zwolinski, L. Ac., Dipl. of Oriental Medicine Acupuncturist & Chinese Herbalist NAET Practitioner (720) 507-4956

Download Intake Forms

Intake Form - Adult
Please use this form for an adult coming for an initial consultation. Please download, print, fill out and bring with you to the appointment. Also, please do not brush your tongue the day of your appointment, as I will be examining the tongue as part of your consultation. Thank you!
New Patient - Adult.pdf
Adobe Acrobat document [431.2 KB]

Initake Form - Child
Please use this intake form for a child under 18 years of age coming for an Initial Consultation. Please download, print, fill out and bring with you to the appointment.
New Patient - Child.pdf
Adobe Acrobat document [345.9 KB]

Book Lakewood Office Appointment

3333 S Wadsworth Blvd, D160 Lakewood, CO 80227

Mon//Thurs/Fri 9 am - 6 pm Tuesday 10 am - 8 pm Saturday (1X month) 9 - 3 pm

Book Arvada Office Appointment

Currently Not Seing Patients

8120 Sheridan Blvd, Ste C-302

Arvada, CO 80003

Wednesdays 3 pm - 7 pm (NAET & Acupuncture only)