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 accepting most forms of insurance but will need to verify your benefits before your appointment.  You can send your full name, carrier, member number, and birthdate or photos of the front and back of your insurance card to  I accept cash, checks, and credit cards (cash and check preferred). 

  • Initial Consultation and Acupuncture Treatment* (90 minutes):
    • no insurance—payment at time of service: $100 
    • insurance: your coverage determines your co-payment + $25 fee for comprehensive initial intake + amount applied to deductible
  • Return Acupuncture Visit (60 minutes):
    • no insurance—payment at time of service: $75 
    • insurance: your coverage determines your co-payment + amount applied to deductible 
  • Cupping or Gua Sha** with your acupuncture treatment is an additional $22.50 
    • same with or without insurance since most in-network insurance does not cover these manual therapies
  • Initial Herbal Consultation (no acupuncture) 30-45 minutes: $75  
  • Return Herbal Consultation (no acupuncture) 20-30 minutes: $45
  • 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. 

** more info about cupping and gua sha