Fusion Health Acupuncture and Massage, LLC

nancy@fusionhealthacu.com

190 East 9th Avenue

Suite #210

Denver, CO 80210

Phone: 303.258.6899

Fax: 720.306.3177

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INTAKE FORM

Other Contacts:

The Center for Integrative Medicine

at University of Colorado Hospital

http://www.uch.edu/conditions/integrative-medicine/index.aspx

Anschutz Outpatient Pavilion

Mail Stop #F743

1635 Aurora Ct. Suite 5501

Aurora, CO 80045

Phone: 720.848.1090

Hoi An Foundation

www.hoianfoundation.org

info@hoianfoundation.org

P.O.Box 181182

Denver, CO 80218