In order to ensure that your visit is as swift as possible, please print and complete the following forms before your appointment. Arriving with the necessary paperwork greatly assists me in limiting your overall wait time.
Please contact your insurance provider to verify that you are covered under your plan and your co-pay amount. If you do not have insurance coverage, please contact me about my rates.
If you have any questions about the following forms or would like to discuss my rates, please contact me for more information.
Blue Cross Blue Shield (BCBS), Employer Health Program (EHP), and most insurances that allow acupuncture coverage are accepted. Please check with your provider to see if acupuncture is covered on your plan. Your co-payment is due at the time of your visit.
If you do not have insurance coverage, please contact me to discuss my visit rate. All payments are due at the time of your visit.
Checks and cash are acceptable forms of payment. Credit cards are not accepted.
Should you need to change or cancel your appointment, I require 24 hours notice so that I have time to offer that space to another patient.
If you cancel with less than 24 hours notice due to an emergency, I will not charge you. Otherwise, the fee for missed appointments is based upon the time reserved for you. The payment will be billed directly to you, and since it is not reimbursable through insurance, you are responsible for covering the cost out-of-pocket. The fee is due before or at the time of your next appointment.
Of course, I prefer never to bill you for such a reason and hope that you will extend me the courtesy of 24 hours notice any time you need to cancel or reschedule.
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