Please use this secure form to request an appointment and our office will respond as soon as possible. Name (required) Phone (required) Email (required) What's your preferred location? (required) —Please choose an option—ChelseaFiDiFlatironUnion Square Preferred Day(s): Preferred Time(s): We accept Aetna, Blue Cross Blue Shield, Cigna and United Healthcare when the specific plan covers out of network acupuncture. Would you like us to check if your plan covers acupuncture prior to your appointment? (yes / no) (required) —Please choose an option—YesNo If you would like us to verify whether your plan covers treatment, we ask for your insurance information at least 24 hours before your appointment. You can either wait for our office to respond to your request to provide us with this information, or submit your insurance information and date of birth below for expedited service. What is your insurance company? —Please choose an option—AetnaBlue Cross Blue ShieldCignaUnited Healthcare What is your insurance member ID (on the front of your card)? Please enter the numbers as well as any letters in the ID. What is your date of birth (needed to verify coverage)?