ACMA Treatment Forms

ACMA Pre-Treatment Form (Condition Form)

This form is to report your pre-treatment conditions before your ACMA treatment starts. All new patients need to complete this form.

You can use either Word format, Email format, or PDF format of the form below:

  • Word Format – To download the ACMA Pre-Treatment Form in Word format, please click ACMA Pre-Treatment Form (Word)
  • Email Format – The email format let you complete the form in email just like you write a regular email.  You do not need to print, fill out, then scan the form.  Due to this reason, many patients regard this format as the easiest format to use.  To use the email format, please download above form in Word format first, then copy and paste the form into your email.  Then you can complete the form in your email.

ACMA Post-Treatment Form (Update Form)

This form is to report your conditions after your ACMA treatment starts.

Visit Patients: Please email us this form 1-2 days before next appointments.  Without this form, your new treatments cannot be prepared, you will not be able to pick up your treatment at your appointment, and you will have to come back the following day to pick your treatments.  So this form can save your time and trip.

Tele-Treatment Patients: Please email us this form several days before finishing current treatments.

After submitting your form, if you have not heard from us, it means we have received your form and everything is fine.  If we need additional information, we will contact you.

You can use either Word format, e-mail format, or PDF format of the form, whichever you prefer.

  • Word Format – To download the ACMA Post-Treatment Form in Word format, please click ACMA Post-Treatment Form (Word)
  • Email Format – The email format let you complete the form in email just like you write a regular email.  You do not need to print, fill out, then scan the form.  Due to this reason, many patients regard this format as the easiest format to use.  To use the email format, please download above form in Word format first, then copy and paste the form into your email.  Then you can complete the form in your email.
  • PDF Format – To download the ACMA Post-Treatment Form in PDF format, please click ACMA Post-Treatment Form (PDF)

Allergic Reactions

When starting a new ACMA treatment or changing to a new ACMA treatment, some patients may get allergic reactions. Allergic reactions are not dangerous and can be quickly cleared if you stop the treatment and call ACMA asap. ACMA has many methods that can quickly stop the allergic reactions.

During ACMA treatments, if you have allergic reactions (any symptoms you did not have before taking the treatment), please stop the treatment and call ACMA asap.

If you have any questions, please contact us asap.