Conscious Health & Wellness - Miriam Pineles, L.Ac., Dipl. OM - 347-878-9619

Patient Information

Please Note: This is a confidential record of your medical history and will be kept in our office. Information contained here will not be released to any person except when you have authorized us to do so.

Personal Information
Sex |
Marital Status | | |

Emergency Contact

Current Physician's Information

Payment Information
Payment Method | |

Licensed Acupuncturist, Board Certified in Chinese Medicine