Brookline Acupuncture Waitlist

Thank you for your interest in AcuBoston!

We are currently accepting new patients in our Dedham office. If you are interested in becoming a new patient in Dedham, please skip this form and call 617-860-2039.

At this time, we are unable to accept new acupunture patients in Brookline. Please fill the form below to join the waitlist.

Our waitlist operates on a first-come, first-served basis.

You will be contacted in the order your request is received. If you submit your insurance, we will verify your benefits when you choose to move forward when a spot opens. Please note that we do not take Cigna.

Location Preference *

Legal First Name *

For accurate insurance billing (if used)

Preferred Name (Optional)

Last Name *

Pronouns (Optional)

Main Treatment Concern *

Are you using insurance? *

Do you have Medicare? *

Medicare ID *

Supplemental Provider *

Supplemental Member ID *

Insurance Provider *

Member ID *

Insurance Card Photos (Optional)

Please upload a photo of the front of your insurance card. This is optional but helpful!

Date of Birth *

Mobile Phone *

Email *

Had acupuncture before? *

Address *

Street Address *

City *

State *

Postal code *

Anything else you'd like us to know?

How would you like us to contact you? *

How did you hear about us? *

By submitting you agree to receive SMS or e-mails for the provided channel. Rates may be applied.