Insurance

We are happy to verify your Acupuncture Insurance coverage with your insurance company. We will contact you upon confirmation of the benefits. Please complete and submit the online form below:

Ways Acupuncture Insurance Submittal Form

ALL FIELDS REQUIRED TO SUBMIT FORM

First Name:
Last Name:
Your Email:
Your Phone #:
Address:
City:
State:
Zip Code:
Referred By:
Insurance Name:
Insurance Telephone #:
Group Number:
Insured ID#:
Insured DOB:
Insurance Type:
HMOPPO EPOPOSAuto Insurance Workers Comp()
Conditions:
Additional Comments:
5 minus 3 =