Patient Forms

Starting 3/01/2021 we are no longer billing insurance. We can give you a “superbill” coded statement to submit directly to your insurance company for reimbursement.

*Please note that due to Covid-19 we cannot accept returns on products from our store.

Patient Intake Form Cancellation Policy & 

Payment Responsibility
Arbitration Agreement &

Acupuncture Informed Consent to Treat
Consent Liability Form Covid Consent Form Covid Symptoms