Clinic Forms

New Patients: Print and fill out this form to speed up the intake process during your first visit.

New Patient Health History Form (PDF, Adobe Reader required)

 

 

 

 

Insurance Verification:  This link takes you to a secure site so your insurance can be verified by my insurance biller.  Please allow 2 business days for a response.

Please fill out the required information to see if insurance will cover your acupuncture treatment.  Keep in mind acupuncture can treat a wide variety of health conditions and you have a better chance of approval if you include pain related issues.   Example: sinus issues and knee pain, fertility and low back pain etc.  To verify insurance click on this secure link:  Insurance Verification