Acupuncture New Patient Forms

New patients can click the link above to download the 5 page packet to complete and bring to their first visit.  Included is a Health History, Privacy Practices, Financial Policy, and Consent Form.  Please complete as thoroughly as possible and feel free to contact me with any questions or concerns.  

​NEW PATIENT CHECKLIST:

• Print, complete, and bring your new patient forms with you or plan on arriving 10-15 minutes prior to your first appointment to complete them
• Eat a snack or meal no more than 2 hours before your treatment, especially if you're new to acupuncture - you can get a little woozy on a very empty stomach
• Wear loose, comfortable clothing that you can roll up to the knee and the elbow.  

FEES FOR ACUPUNCTURE SERVICES

PRIVATE / INDIVIDUAL TREATMENTS:

Initial Visit - $90 for 60-90 mins  
Return Visit - $70 for 60 mins

• Review of your health history and chief complaint
• Single insertion of acupuncture needles while on a massage table in a private treatment space
• Additional therapies (moxa, cupping) may be added

Above prices reflect treatment of a single problem area or condition and a single insertion of needles, with a discount for paying in full at time of service.  Additional problem areas or conditions, additional insertions of acupuncture needles, or additional therapies may be added for an additional charge.  I can bill Personal Injury/Motor Vehicle Accidents (PIP/MVA)  and many local insurance companies directly.  Any co-pays and deductibles are due at time of service. I will gladly issue a superbill at any time for potential reimbursement of fees paid.

Please note that coverage by an insurance carrier is not a guarantee of payment and ultimately the patient is responsible for charges incurred.