Swiss Acupuncture

Choose clinic location

Appointment details

Are you a new or existing patient at this clinic

Choose a service Services are specific to each office

Choose a provider Select the practitioner or skip this step if you do not have a preference

Reason for visit

Patient name

Email address

Phone number

Available times

Mon, Jul 13

No availabilities found on this day.

Tue, Jul 14

No availabilities found on this day.

Wed, Jul 15

No availabilities found on this day.

Thu, Jul 16

No availabilities found on this day.

Fri, Jul 17

No availabilities found on this day.

Sat, Jul 18

No availabilities found on this day.

Insurance verification

Insurance Information

This message is for new patients

If you want to use insurance for your visit please fill out the fields below so that we can verify your coverage

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

City

ZipCode

State

Covered under someone else's insurance plan? Select "yes" if you are covered under someone else's insurance

Patient relationship to insured

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

Auto Accident? No-Fault / Personal Injury

Date of accident Please bring your authorization form to the office

Case/Claim #

Case Manager's Name

Case Manager's Phone #

Address to submit claims

Employment Accident? Workers Compensation

Date of injury Please bring your authorization form to the office

Case/Claim #

Employers Name

Employers Address

Insurance company name

Insurance company phone

Insurance company address

I have read and accept the Terms of Use and Privacy Policy

*By providing your telephone number to Unified Practice you agree that a representative of Unified Practice and/or contracting clinics can place calls or text messages to the number provided, including appointment reminders and telemarketing, using an automatic telephone dialing system or an artificial or prerecorded voice. Your consent is not a condition of using or purchasing our goods or services.

© 2011-2020, Unified Practice, Inc. f.k.a.Chinese Medical Technologies, Inc. All rights reserved. The Unified Practice TM product, application, its components and various applicable related content and methodologies are proprietary to Chinese Medical Technologies, Inc., and are U.S. and International patent pending. The “Unified Practice” name, logo, and application icon are trademarks of Chinese Medical Technologies, Inc.

Privacy Policy | Terms of Use