15 Minute Free Evalution (a $60.00 value)

Please complete the following information. The information will only be used for the purpose of this evaluation.










List your 5 most important health concerns and the length
of time you have had them.


Check if you have had any of these symptoms in the past 6 months.

Fatigue
Poor sleep
Sinus problems
Headaches
Nausea
Bloating
Constipation
Diarrhea
Poor memory
Depression
Stress
Anxiety
Shortness of breath
High blood pressure
Palpitations
Menstrual issues
Fertility issues
Lack of energy
Diabetes
Thyroid problems
Skin problems
Autoimmune issues
Food allergies
Neck and shoulder pain
Hand pain
Foot pain
Back pain



If you responded to any of these questions, you are likely looking for answers. You can choose from the following options.

I would like to come in to the office for an initial free 15 min quick assessment to see if Nan Cameron can help me.
I would like to come in to the office for a full new patient 1.5 - 2 hr assessment, extensive nutritional consultation, acupuncture treatment, and to discuss Chinese herbs and/or supplements (if needed).
I would like the acupuncturist to call me to discuss my health problem before making an appointment.
You are welcome to call our office, (910) 342-0999, to schedule an appointment or obtain more information.