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Acupuncture New Patient Forms

New patients can click the link above to download the 4 page packet to complete and bring to their first visit.  Included is a Health History, Privacy Practices, and Consent Form.  Please complete as thoroughly as possible and feel free to contact me with any questions or concerns.  You will sign my Financial Policy when you arrive at the office.

NEW PATIENT CHECKLIST:
  • Print, complete, and bring your new patient forms with you or plan on arriving 20 minutes prior to your first appointment to complete them
  • Eat a snack or meal no more than 2 hours before your treatment
  • Wear loose, comfortable clothing that you can roll up to the knee and the elbow.  I treat predominantly in recliners and focus on these areas of the body.
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FEES FOR ACUPUNCTURE SERVICES

GROUP TREATMENTS:

Initial/Return Visit - $25 for 60 - 75 minutes
  • Brief consultation about your chief complaint(s) - 5 mins
  • Insertion of Acupuncture needles while seated in a zero-gravity recliner in a shared treatment space

PRIVATE/INDIVIDUAL TREATMENTS:


Initial Visit - $65 for 75 mins       Return Visit - $50 for 60 mins
  • Review of your health history and chief complaint(s) - 5-20 mins
  • Insertion of Acupuncture needles while on a massage table in a private treatment space
  • Additional therapies (moxa, cupping, electro-acupuncture) as needed

Above prices reflect a discount for paying in full at time of service. I can bill Personal Injury/Motor Vehicle Accidents (PIP/MVA)  and most local insurance companies directly.  Any copays 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.

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