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Welcome to Lifeline Acupuncture & Herbs Clinic


We are excited to have you as our new patient! To save your time, please complete all forms listed below and bring those with you. Otherwise, we kindly ask you to arrive at least 15 minutes prior to your appointment time.


New Patient Forms (Please print & read all forms):
1. Registration & Medical History

2. Arbitration Agreement / Consent Form

3. Notice of Privacy Policies

4. Financial Agreement

**Veterans Choice Program

Insurance Information


Please contact your insurance carrier to verify coverage and benefit-eligibility may vary by member’s policy. If you have insurance please bring your card with you to your visit. We will gladly discuss your proposed treatment and answer any questions relating to your insurance. Your insurance is a contract between you, your employer, and the insurance company. We are not a party to that contract. We must emphasize that as medical care providers, our relationship is with you and not your insurance company.


Accepted Health Plan Search

You can also submit the form below, and we will respond to you by either phone, e-mail, or mail, whichever you prefer.

If you have an inqury about Personal Injury or Workers Compensation, Please call our office directly.

Your Health Insurance Inquiry were sent successfully! We will get back to you as soon as possible. Thank You

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