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New Patient Forms

When you arrive for your first acupuncture appointment you will have already printed & filled out your new patient forms and insurance forms at home. Or please arrive 20 minutes early to complete them. treatment if you haven't called and verified your insurance coverage.  We will require payment at the time of your The acupuncture intake form asks questions about your current state of health, past illnesses, and family history. These questions are important because the holistic approach of Oriental medicine takes everything into account. Your current symptoms may not seem related to past health issues, but our bodies are complex landscapes and everything that happens to them leaves its mark.  Health History Forms (pdf)
Mandatory Arbitration Forms (pdf)

Many common health insurances cover acupuncture services, but not all of them.  It's best to call your insurance company prior to your first visit to verify what your benefits and deductible are and whether you need pre-authorization.  We have provided you with the questions you need to ask your insurance when you call them on this form. Questions to Ask Your Health Insurance (pdf)

"My shoulder pain is gone!  The swelling in my knee is all gone and the pain is much less.  When can we do this again?"

Anna Zell LAc., MAOM
Renee Rodden LMT #5860

Pearl Acupuncture and Healing Center
38530 Pleasant St., Sandy, OR  97055
(503) 668-7631
(503) 810-6517 massage

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