Insurance & Patient Forms We accept most major insurance plans for acupuncture treatments. Please contact us to verify coverage NEW PATIENT INFORMATION FORM NEW PATIENT CONSENT FORM ASSIGNMENT OF BENEFITS FORM FINANCIAL AGREEMENT FORM Schedule a Consultation Name * First Name Last Name Email * Phone * (###) ### #### Reason for visit * Pain Management Stress Relief Women’s Health Other (Be Specific) Message * Where did you hear about us from? Select Facebook Google Friend/Colleague Other Thank you, we will be in contact shortly!