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This form can be printed on your printer and filled out before your first appointment to save time. Please bring this with you to your appointment. Do not e-mail.
Thank you.
Press button to Download Form
in PDF format below.
Fee schedule:
(Updated January 2024)
Initial acupuncture treatment
( Includes intake ) $90.00. (70 min.)
Follow-up acupuncture treatment: $70.00 (55 min.)
Follow-up acupuncture treatment
(age 70+): $60.00 (55 min)
Ear acupuncture only: $60.00
Herbal wellness consult:
$60.00. (30 min.)
- separate charge for herb formulas -
Treatment Tips
* It is good to have something to eat about an hour before your treatment.
* Wear comfortable clothes that allow access to areas below the elbows and knees.
* We ask that you please refrain from wearing any perfumes, scented lotions or oils to your appointment.
* Please turn your cell phones off or silent when entering the treatment room.
* If possible, set aside time after your treatment to rest.
Payment Policies
* Payments are due at the time of service. We currently accept cash, check or credit/debit/health savings cards.
* Cancellations: Kindly give 24 hour notice if you are unable to make your appointment.
* There will be a fee of $65 for missed (no show) appointments or same day cancellations. I respect your time. Please be respectful of mine as well.
* For your privacy, please do not e-mail or text your personal health information.
Cash & Checks (preferred)
Credit / Debit Cards / Health Savings (accepted)
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Please note:
We do not bill insurance. We are happy to provide you with a receipt which you can submit for reimbursement, but we are not "in-network" with any insurance provider, and therefore make no claim that you will receive any reimbursement for your visit.
Important note:
We are in the process of making sure our website is ADA compliant, so that everyone can access our information with ease.
If you are having trouble accessing the content on this site for any reason, please call 720.684.8865 at any time, and we will get back to you promptly. We are committed to all of our patients being able to access our services easily and equitably.
Sunflower Community Acupuncture
For questions and appointments; call 720.684.8865
email link below.
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