Forms
Print, complete, and sign all the forms below. Please bring these completed forms with you to your initial appointment.
- New Patient Form
- Notice of Privacy Practices
- Financial Arrangements
- Assignment of Payment & Late Cancellation
- HIPPA Notice (Not necessary to print)
Insurance
My practice accepts out-of-network insurance for acupuncture patients. In order to best serve you, we verify your insurance benefits prior to scheduling your initial appointment. Please click on the link below and complete the online form. You will be contacted as soon as the benefits are established.