Insurance

Salado Acupuncture accepts various types of insurance. We are happy to check your insurance benefits for you, to see if your policy covers Acupuncture. Please complete the form below so that we can contact your insurance company regarding your benefits.

Insurance Benefit Verification

* Indicates required field

Patient Name *

Date of Birth *

Patient Address *

City/State/Zip *

Primary Policy Holder Name *

Relationship to Patient *

Insurance *

Insurance Contact Number *

Policy ID # *

Group ID # *

Patient Contact Number *

Authorization *

By submitting this form I authorize Salado Acupuncture to contact my insurance company to verify my benefits.

Submit