Patient Forms

Starting 1/1/20 we are billing select insurance plans. We can check your insurance and let you know if we can bill for you. The other option is to give you a “superbill” so that you can send to your insurance for billing and then you would receive the reimbursement.

Patient Intake Form Cancellation Policy & 

Payment Responsibility
Arbitration Agreement &

Acupuncture Informed Consent to Treat
Consent Liability Form