Insurance & Forms

Treatment Fees

 Initial Evaluation & Treatment Pain Management    $85.00
 Initial Evaluation & Treatment for Internal Medicine  $125.00
 Initial Evaluation & Treatment for Fertility  $145.00
 Subsequent Visit    $85.00
 Herbal Medicine  $15-25/week average
 Each visit runs 50 minutes in length

Initial evaluation for issues other than pain runs 90 minutes in length

 

Insurance and Payment

The office accepts Visa, Master Card, Check or Cash as payment. I am a preferred provider for United Health Care, CIGNA and  Blue Shield of California. Contact your provider to find out if your plan has acupuncture coverage, deductible amount, co-pay and if coverage is limited to any specific conditions ( like back pain or anesthesia).  I have a billing agent and will bill for you should you have coverage for the condition that you’re seeking treatment.

 

Please download, print and bring completed form to your next appointment: 

Medical History Form (.pdf file)

Female Fertility History (.pdf file)

Male Fertility History (.pdf file)

Basal Temperature Chart (.pdf file)

Metabolic Assessment Form (.pdf file)

Neuro Assessment Form (.pdf file)