forms and fees



My office is located at 3804 Piedmont Avenue, at the corner of Piedmont and Yosemite.  It is on the second floor (there is one flight of stairs and no elevator), with the entrance on Piedmont Avenue.  There is metered parking on Piedmont Ave and free two-hour parking on surrounding streets (Yosemite, Rio Vista).  


You will be able to fill these forms out online if you book through Blue Sky Acupuncture Studio.  If you prefer to fill out forms on paper, you can download them here:


I am not currently accepting insurance, but will be in-network with some companies starting in October.  If you have a PPO plan I can provide you with a superbill to submit to your insurance company for reimbursement.  I accept cash, checks, and credit cards (cash and check preferred). 

  • Initial Consultation and Acupuncture Treatment* (90 minutes): $100 
  • Return Visit (60 minutes): $75 
  • Services added on to acupuncture treatment:
    • Cupping or Gua Sha Treatment +$22.50
    • Initial Herbal Consultation +$50.00  (follow up is no additional charge)
  • Initial Herbal Consultation (no acupuncture) 30-45 minutes: $50  
  • Return Herbal Consultation (no acupuncture) 20-30 minutes: $30
  • Cupping or Gua Sha only 30 minutes: $40

* if you are booking an appointment for a small child please write a note in the scheduling software and include a good time to reach you–the in-person appointment will be shorter and I will want to arrange a time to do an intake with the parent over the phone.