This form is used to verify details necessary to determine what benefits you may have.
You will receive a call when we have obtained this information .
Many insurance companies now pay for acupuncture treatments. Should your insurance company not cover this therapy, The Balance Health and Wellness Center is contracted with most insurance companies to provide a discounted rate. Enter your information below and we will gladly qualify your insurance for you. Be sure to include the best contact number should we need more information.
*NOTE you most complete each box below to submit the form correctly*