Medical Acupuncture for Physicians
AC72 Application

Tempe Mission Palms Hotel & Conference Center, Tempe, AZ
Module One: November 10-13, 2022
Module Two: February 2-5, 2023
Module Three: June 1-4, 2023

The final day of each in-person module ends at noon local time.
There will also be additional shorter meetings delivered via Zoom in between the primary units.

In addition to completing this form, the following documents are required for your application to be considered. You must submit them via email to

  • Résumé / CV
  • Photocopy or scan of your current medical license
  • Statement of plans on your interest in acupuncture and how you will incorporate it into your practice. (For military applicants, please include in your statement confirmation of your base command’s endorsement of your training and an acupuncture-friendly clinical setting.)
  • Documentation of COVID-19 vaccination

The fields indicated with an asterisk (*) are required.

    Name And Professional Information


    Contact Information

    Home Address:

    Military Personnel & Government Employee Applicants Only


    300-Hour CME course: $12,650 by credit card, $12,350 by check($13,150 after October 10, 2022)Full-time Resident or Fellow (self-pay): $10,550 by credit card, $10,250 by check($11,050 after October 10, 2022)

    Indicate method of payment:*

    CheckPreferred - Payable to Helms Medical Institute, 2520 Milvia Street, Berkeley, CA 94704 Credit Card - onlinePay online at Card - by phoneCall 510-649-8488 between 9am and 2pm Pacific Time or fax to 510-649-86923rd Party Payment

    All training activities will take place at the Tempe Mission Palms Hotel & Conference Center, Tempe, Arizona. You are requested to lodge at the hotel where a group rate has been arranged. A conference day use fee of $89 per day is required of participants who choose to stay elsewhere or room with another course participant.

    All participants, HMI staff, and HMI preceptors must be fully vaccinated against COVID-19 (boosters encouraged) to participate at in-person activities. Additional health and safety precautions will be implemented at the in-person teaching activities and these measures must be followed by all attendees.

    For additional information about this course, call 510-649-8488 or e-mail Once you have submitted this online application you will receive a confirmation email.