Policies/Forms
Payment
Payment may be made by cash, check or credit card at the time of treatment. If you need to cancel your appointment please do so at least 24 hours before your scheduled appointment time. Failure to do so will require that you pay for the treatment in full.
Insurance
Blue Cross Blue Shield Policies that cover acupuncture are accepted. Please check your policy to determine if you have coverage. Other health insurance providers may cover acupuncture, therefore a receipt suitable for submission for insurance or flexible spending plan reimbursement is provided.
Intake Form
Please print and complete the intake form prior to your first appointment. Scroll down the page to access the downloadable form.
Informed Consent
The form is available for your review. I will go over it with you at your first appointment and ask you to sign it at that time. Scroll down page to view or download the form.
HIPPA Policies and Disclosures
HIPPA policies and disclosure form are available for your review. Scroll down the page to view or download the forms.
| initial_intake_awvt_2-4-17.pdf |
| acupuncture_informed_consent_1-25-16.docx |
| consentforuseordisclosureawvt.docx |
| noticeofprivacypracticesawv-1.docx |