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Evolve Health + Wellness
Telemedicine appointments are now available at
Evolve Health + Wellness
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Evolve Health + Wellness
Appointment details
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Acupuncture Follow-Up (Xin Tao, LAc)
Free Initial Consultation
Duration:
minutes
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Frank Butler
Nini Mai
Xin Tao
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Fri
, Jan 29
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Sat
, Jan 30
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Insurance verification
Insurance Information
If you have an insurance policy that covers acupuncture, or have insurance but are unsure whether acupuncture is covered, and would like to use your coverage for your visits, please provide us with your insurance information.
If you want to use insurance for your visit please fill out the fields below so that we can verify your coverage
Choose
yes
no
Name of Primary Insurance
(Blue Cross, Aetna, Anthem etc.)
Insurance Type
(HMO, PPO etc.)
ID # on insurance card
The ID number on your insurance card
Group number
Insurance Provider Phone Number
Located on back of insurance card
Claim address
Located on the back of insurance card
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Covered under someone else's insurance plan?
Select "yes" if you are covered under someone else's insurance
Choose
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Patient relationship to insured
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First Name of Insured Party
First Name of the primary policy holder
Middle Name of Insured Party
Middle Name of the primary policy holder
Last Name of Insured Party
Last Name of the primary policy holder
Insured Party Date of Birth
Date of birth of the primary policy holder
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