Information, forms and policies

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(207)236-3601

Mary had a 3rd cardiac stent to repair a 70% blockage but "...immediately after the stent was inserted she had a horrific migraine headache. For the next 2 weeks the migraines continued. She went to see Jolinda who immediately dimmed the lights. She painlessly inserted two acupuncture needles in Mary's legs and one in her hand. Mary said she could feel the grip of the migraine letting go! She left with no pain! It has been like a miracle. If you have migraines you know what they can do to you. All we can say is "Wow"

Ken Gricus

 

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Client Information
and Office Policies

  • Fee for services is due at the time of the office visit. I accept cash, check, VISA, MasterCard and Discover.

  • If your insurance policy covers acupuncture, I will provide you with the appropriate statement for your reimbursement including diagnostic and treatment codes.

  • A small fee will be charged if an appointment is cancelled without 24 hour notice.

  • If I assess that your case will be better served by another holistic modality or conventional health care, I will refer you to appropriate professionals according to my best ability.

  • I do not make recommendations about physician prescribed medications but, instead, refer you back to that physician for further assessment. Improvements in your symptoms may signal a need to reduce or eliminate medications. Do not try to change your medications without professional medical advice.

  • In case of emergencies, please contact your primary care physician or go to an emergency room as soon as possible.

Forms

Download any of the below forms
to fill out before inital visit

Registration Form

Health History Questionnaire
Men
Women

Clients with Lyme Symptoms
Symptom Checklist
Primary Symptoms Evaluation
Current Rx and Supplements

Notice of Privacy Practices and Notice of Health Information (HIPPA)

 

 

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