Insurance & Forms | Neuroloqi Acupuncture
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Attention New Patients

When you schedule online, you'll be able to fill out your forms on our patient portal.

 

If you are unable to for any reason, use the following link to fill out paper forms and bring them with you on your first visit! 

Your insurance may cover acupuncture!

We are in-network with the following companies:

We accept No Fault Insurance & we will accept Workman's Compensation in the near future!

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We are happy to verify your acupuncture benefits for you!

What you need for your initial visit:

  • Insurance Card

  • Medical History

  • Medication List

  • Diagnostic reports of imaging pertaining to your condition

  • Loose clothing is recommended, but not necessary. There are sheets to drape you.

  • Cash, Check, HSA or FSA or Credit Card.

We understand that things come up, but we have an active waiting list. If you need to reschedule, please provide us with at least 24 hours notice, or you will be subject to a $25 late cancellation fee.

It is our policy to verify everyone's insurance benefits. If we are unable to for any reason, you will be responsible for the full cost of your treatment at the time of service. Should we receive payment from your insurer, we will gladly issue a refund to you.

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