Yin Yang Channel

Forms

Please use the tabs below to view the different forms we have to offer.

 

Insurance Verification Form​

 

Please click “Download Form” below to download the Insurance Verification Form. You can complete the form either by filling it out on your computer or by printing it and filling it out by hand. After completing the form, please scan it and email it to [email protected].

Please remember to include scans or very good pictures of the front and back of your insurance card(s).

Download Form

 

Confidential Medical Questionnaire

Please click “Download Form” below to download the Confidential Medical Questionnaire. You can complete the questionnaire either by filling it out on your computer or by printing it and filling it out by hand. After completing the questionnaire, please scan it and email it to [email protected].

Download Form