Patient Forms

These forms will help you expedite your visit

insurance verification

As a courtesy we will verify your acupuncture benefits before arrival so you know if insurance will cover your treatment. Please fax this back to us: 773.227.9150

new patient forms

Please fill out and sign these new patient forms and bring them in during your first visit or fax them to us at: 773.227.9250 before your visit.

Feature 3

The following is placeholder text known as “lorem ipsum,” which is scrambled Latin used by designers to mimic real copy. Nulla eu pretium massa. Nulla eu pretium massa.