Insurance Preauthorization Form:
Find below the Insurance Pre-Authorization Form. It is for your personal use only. It is designed to help you clarify your insurance coverage when receiving services by an Out-Of-Network Provider psychotherapist and/or acupuncturist.
- If you have any questions please feel free to call me or email me:
- email: firstname.lastname@example.org
- h/o: 323. 850.6508