Outdoor Acupuncture Appointment Request Form for Boston Acupuncture Project

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Host your own backyard community acupuncture party! Priced $150-$300 sliding scale plus travel and equipment. This form will be open through September or October, depending on weather. Please fill out your information below or just call or text our lead acupuncturist, Ren, if you are interested: 617-506-3868

What's your name? *

What is the best way to reach you? *

What is the location where you would like to host outdoor acupuncture? Please include your zip code. *

Travel costs are charged at $1.00 per minute. Costs will vary based on traffic.

Equipment needed for your location: *

pop-up tent for shade, measures 10'x10' - add $50

Zero Gravity recliners - up to 4 available - add $10 per recliner

None! I have shade and comfortable outdoor furniture.

Other:

Required

What days/times are you thinking? (Please fill use "Other" for specific dates.) *

Monday morning

Tuesday afternoon

Wednesday morning

Thursday afternoon

Friday morning

Friday afternoon

Sunday morning

Sunday afternoon

Other:

Required

What types of treatment are you looking for?

New patient acupuncture with customized treatments (up to 3 people per hour)

Return patient acupuncture with customized treatments (up to 5 people per hour)

Relaxation acupuncture treatents or ear seeds (up to 10 people per hour)

Other:

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