Before You Come In
Before Your First Treatment

Please download and complete the following forms prior to your first treatment. Alternatively, we have copies in the office you can fill out once you get here. Please allow an extra 15 to 20 minutes prior to your appointment to complete the forms in our office.

Medical History
Disclosure Statement
Consent to Treat


If you are unable to keep your appointment, please note that we have a 24 hour cancellation notice policy. Thank you for respecting this.

Payment is required at the time of service. I accept cash, checks and credit cards. The cost of an initial visit is $105. Subsequent treatments are $75, and NET treatments are $45-$60 depending upon length of visit. Although I do not accept co-payments for insurance, I am happy to give you a form to send to your insurance company for reimbursement.

Insurance coverage for acupuncture varies. Contact your insurance provider to learn what kind of care is covered. You might ask your carrier:
•Will my plan cover acupuncture?
•How many visits per year will my plan carry?
•Do I need a referral before beginning treatment?
•Do I have a deductible?
•If I have a deductible, has it been met for the year?


Please plan on spending up to 90 minutes for your first appointment.  Make sure that you have eaten something beforehand, do not come hungry or overly full, and if possible wear loose clothing.

I look forward to our first visit.  Please do not hesitate to call if you have any questions. (208) 920-0312.
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Elements of Health | 76 N Main St, Suite 204, Driggs, Idaho 83422 | 208-920-0312 | email us
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