New patients
Welcome to Affinity Acupuncture! Before your first appointment, please download and complete our New Patient Forms. This will save you time when you get to the clinic.
How to get started
Download & complete the forms
Download the new patient forms (PDF) and complete them on your computer or phone. The PDF opens in Preview (iPhone) or Adobe Reader (all devices).
Contact us before you visit
Call or email us to make an appointment so we can verify your insurance.
Your first consultation
A comprehensive 60–80 minute consultation, followed by an acupuncture treatment.
New patient forms
Please take enough time to read every question and answer in detail. We recommend that you download and complete the forms before your first visit. Your completed information is held completely confidential.
What’s inside the PDF
- Patient information and emergency contact
- Insured person’s information: insurance company, policy and group numbers
- Acupuncture informed consent
- Financial agreement, including check-in, payment of bills and our cancellation policy: we require a minimum of 4 hours’ notice if you are unable to keep your appointment, otherwise a $50 missed appointment fee will be charged. Arriving 20 minutes or more after your scheduled time is considered a missed appointment, subject to the same fee.
- Notice of privacy practices
New patient forms
After you complete it
Email the completed paperwork to contact@affinityacucare.com at least 24 hours ahead of your first appointment. This will save you time when you get to the clinic.
Email the completed formsNew patient consultation & acupuncture
For every new patient, Affinity Acupuncture provides a comprehensive consultation to understand your concerns and set goals within a completely personalized treatment plan, including health history overview, nutrition and more. Based on the findings, the practitioner will recommend types of treatment and provide an acupuncture treatment following the consultation.
We accept most insurances
For your convenience, please download the new patient form and contact us prior to your visit so that we can verify your insurance.
- Auto accident
- Personal injury
- Worker’s compensation
- General insurance
- Others
Insurance carriers
- Aetna
- Blue Shield of California
- Cigna
- Kaiser Permanente
- United Healthcare
- Anthem
- American Specialty Health
- Optum Physical Health
- SCAN
- Alignment
- Clever Care
Ready to schedule a visit?
Call us or reach out to make an appointment before visiting the office.