Please use this form to contact our Clinic only about basic information. This is not a to be used to communicate any personal medical information. This form cannot be used to diagnose or make a treatment plan for any health condition. If you wish to schedule an appointment with Red Door Acupuncture to discuss a medical issue or treatment, please use the scheduling buttons displayed above and below this form. Once you have had your first appointment with our clinic, you will be using our secure patient health records system for communication with our practitioners and staff. If you feel you are experiencing a medical emergency, please contact 911 and/or access emergency medical services immediately.