Insurance

We are happy to verify your Acupuncture Insurance 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, B.S., A.P.
2427 University Blvd. West
Jacksonville, FL 32217
Office: 904-739-5808
Cell: 904-704-8824 (preferred)
kristolhealingcenter@gmail.com