Client Intake Forms

Please complete these documents as thoroughly as possible. Some of the conditions may seem unrelated to your condition, however they could play a significant role in the diagnosis and treatment. All information is strictly confidential.

click here for AWC Intake Form

Venice Acupuncture & Wellness Clinic
Lady Melody Clancy, M.Ac., L.Ac., D.O.M.
341 Miami Ave West
Venice, FL 34285
941 445 4940
lady.clancy@gmail.com

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