initial intake paperwork
--- required documents have a red * next to them
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INITIAL PATIENT INTAKE *
You may be accustomed to filling this out at your western doctor's office prior to any initial visit. It asks for information about your reason for coming plus past medical history.
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ARBITRATION AGREEMENT *
This document will also be familiar from other medical offices.
CLINIC POLICIES *
This outlines the policies that we follow at The Living Point.
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CONSENT TO TREAT *
This gives your permission to be treated. If the patient is a minor this will need to be filled out by the parent or guardian. Please note there is a different form to download in this case.
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PRIVACY POLICY
This document outlines how we ensure the privacy of your data.
This document is made available for your records/reference. | ||||||||||||
Important Notes and Information for Your First Appointment |
If you have never been to Living Point Acupuncture and Oriental Medicine, please do call or email and let us know how we can help you. Your first appointment will usually last 60 to 90 minutes. If this will be your first time receiving acupuncture, we're honored to serve you and will make sure your experience is a great one!
Firstly, your privacy is of utmost importance to us. You can download a copy of our Privacy Policy or ask for a current copy at the office. New patients will need to fill out an Intake Form which will provide the standard medical history, insurance information, and contact information. This will all feel very similar to your first time seeing a new western doctor. Above are links to the initial paperwork that you will need to have filled out prior to beginning treatment. Feel free to download and bring filled-out to your appointment, otherwise you are welcome to come 15 minutes early in order to do this. If you need to cancel, please give us 24 hours notice. Insurance Patients, Personal Injury and Workman's Compensation: If you have health insurance, please contact your insurer before your visit to verify whether acupuncture is a covered service. We take most insurance plans, but feel free to contact us as we can verify your eligibility for you. Doing this 2-3 business days before your appointment will ensure that we have all your insurance details in-hand prior to beginning treatment. Many insurers offer acupuncture coverage, some do not. You are responsible for your co-pay or cash payment at the time of services. For those insured under an HMO plan, you will need a referral from your primary care physician or the specialist you are seeing in order to begin acupuncture treatment. If your injuries occurred as a result of a motor vehicle accident, your case is considered a “PI” case (“personal injury”) and the paperwork for a new PI case is different. Please let us know when you call if yours is a PI case and we will mail or email your paperwork to complete before you arrive. If your injuries occurred at your workplace and this is a Workers Compensation (WC) case, you will need prior written authorization from your claims adjuster to receive acupuncture treatment and the paperwork for a WC case is also different. Please let me know when you call if yours is a Workers Comp case and we will mail or email your paperwork to complete before you arrive. Important Note Regarding Personal Injury Cases: We cannot treat you without prior WRITTEN authorization from your claims adjuster, even if your MD has written a prescription for acupuncture. The State of California has detailed rules about how and when we can commence treatment for Personal Injury cases. |