Forms and Fees
Please fill out all medical forms before your appointment. Download and print insurance information, consent, privacy and financial forms here.

Insurance & Fees

I am currently in-network with and bill to the following insurance companies:

  • Kaiser – First Choice & out-of-network plans
  • Regence/Uniform
  • Premera Blue Cross
  • Lifewise
  • Aetna
  • First Choice
  • United Healthcare
  • Personal Injury Protection (car accidents)

*Please note that my being in network with your insurance company is not a guarantee of coverage. Insurance plans vary and not all plans include acupuncture coverage for all diagnoses. Please confirm with your insurance company that you have acupuncture coverage for your particular diagnosis before making an appointment. Should your insurance company deny the claim for your treatment, you will be responsible for the total.

** Medicare does not cover acupuncture, and if you have Medicare your secondary insurance may cover acupuncture. Please confirm this with your insurance company.


Fee schedule attached to downloadable forms. Click here to download.

If you are a first-time patient, please contact us prior to making your first appointment.