What pain points are you seeking relief for?
Chronic pain Stress and anxiety Insomnia Digestive issues Fatigue
How long have you been experiencing these issues?
Less than 3 months 3-6 months 6-12 months Over 1 year I'm not sure
What is your main goal for seeking acupuncture and wellness?
Pain relief Stress reduction Improved sleep Better digestion Boosted energy levels
How did you hear about Ocean Ki Acupuncture and Wellness?
Referral Online search Social media Event or workshop Other
Are you open to trying new holistic approaches for your well-being?
Absolutely Maybe, need more information Not sure Prefer traditional methods Not interested
All set, how can we reach you?
Name
Email
Phone
(Details here)
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