Forms and More
If you are a new patient, please print the following form(s), complete them and bring them when you visit our office. Infertility patients are required to fill both the New Patient Information Form and Infertility Patient History Form.
- New Patient Check List
- Patient Record Form
- Medical History Form
- Infertility and Woman’s Health History Form
- Basal Body Temperature Chart
- Basal Body Temperature Chart Instruction
- Consent Form
Let us know if you have any questions about the forms.
We are in-network providers with United Health Care and Blue Cross Blue Shield (BCBS), and we are an out-of-network provider of Aetna. We will directly bill these insurance companies. We take care of initial and ongoing credentialing with your insurance for you if your insurance plan covers acupuncture. To find out what coverage your insurance plan offers, please feel free to contact us, by calling us or emailing us. We will contact you on your insurance coverage and co-payment information. You can simply bring your insurance card to our office, and we will work with your insurance company on your coverage. We want to help you get the most benefit from your insurance plan. We also accept Flex Spending Accounts (FSA).
Office Hours and Office Location