Insurance

We are happy to verify your Mental Health / Psychological, Behavioral Health and Acupuncture /Acupressure coverage with your insurance company; please complete and submit the online form below:

Kristol Healing Center Insurance Submittal Form

ALL FIELDS REQUIRED TO SUBMIT FORM

First Name:
Last Name:
Your Email:
Your Phone #:
Address:
City:
State:
Zip Code:
Referred By:
Insurance Name:
Insurance Telephone #:
Group Number:
Insured ID#:
Insured DOB:
Insurance Type:
HMOPPO EPOPOSAuto Insurance Workers Comp()
Conditions:
Additional Comments:
5 minus 3 =

 

Kristol Healing Center
 Mariellen Kristol, A.P.
2427 University Blvd. West
Jacksonville, FL 32217
Office:904-739-5808
Office:877-436-9858
Cell:904-704-8824