Once we verify your insurance (and before you come in for your appointment), please download and complete the Intake, Consent, & Office Policies Form. Please bring completed documents and your insurance card with you to your Initial Visit.
Questions or concerns? Call the office at (443) 219-1220
Please make sure to complete ALL sections with an * in order for the form to be submitted correctly. You will be prompted if a section is not completed. If all sections are completed correctly, the SUBMIT button will turn a bright blue and allow you to click submit. Thanks!
Please fill out the following form and click Submit. We will contact you as soon as possible with the quoted coverage from your insurance company and to schedule your Initial Visit.
If you are a new patient to Acupuncture & Wellness Center and are looking to book an acupuncture appointment, please call 443.219.1220 or email firstname.lastname@example.org. We will be happy to speak with you about setting up an appointment, discussing any needed paperwork, and completing a courtesy insurance verification to find out if your plan carries any acupuncture therapy benefits.
+1.443.219.1220 • 8813 Waltham Woods Road Suite 102 Parkville MD 21234 US
Copyright © Acupuncture and Wellness Center. All rights reserved. Website by Concepts By Q