Please call 617-859-3036 extension 0
Please arrive 20 minutes
prior to your appointment to fill out the necessary paperwork or you may download the
necessary forms and bring them with you.
If you wish to use our sliding
scale fee structure, you will need to provide income verification on
your first visit.
If you wish to download the
intake forms, click on the links below, fill them out completely and
fax them to us at 617-859-0965 or bring them in with you. We need each
of the following completed forms to process your intake:
- Intake Form
[all 5 pages]
- Informed Consent
form
- Financial Intake Form
(This form is only needed if you wish to participate in the
sliding scale)
- Front and back photocopy of your health insurance card
- Privacy
Policy: for your information
- Grievance Procedure
If you have any questions on
how to fill out the forms, please call our receptionist at 617-859-3036
x 0.
For more detailed information
on acupuncture, herbal treatments, and shiatsu therapies
please download this
form.
If
you have been referred to us for treatment and are HIV+, please go to
our ACP appointment
page.
We look forward to providing
you with excellent care. |
