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Medical insurance form

Instructions

Please fill out this form if we have contacted you to verify that you have acupuncture coverage with either Aetna, Cigna or CareFirst / BlueCross BlueShield. If you do have coverage, this form is required for us to submit claims for your acupuncture sessions. If you would like to know whether or not your insurance policy includes benefits for acupuncture, please fill out our short Verify Your Benefits form.

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