Insurance
We are covered by most insurance companies. Contact your employer or individual insurance company to assure your coverage includes our providers' services. Out of network benefits are frequently covered. We will be happy to bill your insurance company for you.
These are some of the insurance plans for which individual practitioners are preferred providers. Please click on or call your plan below to find out if you are covered by a particular provider:
Insurance plans:
Check with your plan to find out if our providers are part of your specific network.
Regence Blue Shield
Uniform Medical Plan
Premera/Lifewise
First Choice Health Network
HMA
Kaiser - Only covers Naturopathic physicians as a specialist and does not cover preventive codes such as well child or annual exams without pre-approval from Kaiser. Please fill out this noncovered services agreement prior to your visit. Click here
Medicaid: Please click here to review and sign non-covered services prior to your appointment.
Molina
Coordinated Care - Apple Health only.
Medicare
Medicare - Some Medicare Advantage plans cover naturopathic medicine. Please check with your insurance to make sure your plan covers naturopathic medicine. Medicare and Medicare gap plans do not cover naturopathic medicine. We ask that you sign this form before your first office visit. Click here
We do not accept United plans.
New Patient Intake Forms
To get a form:
You are welcome to print or download the appropriate form from below.
Stop by and get a copy from our office
If there is enough time, we can mail you a copy.
To fill out the form:
Fill out the form by hand.
You can also fill the form out electronically with your PDF technology or by doing the following:
Download the appropriate form below.
Go to PDF Escape.
Click on - Upload PDF to PDFescape and upload the form you just downloaded.
Fill out the form. There is a freehand option you can use to sign the form.
Save and download PDF (left side green box with down arrows).
Email to lhc@londonhealthcenterinc.com
Options to return the form:
Return the form by dropping it off at our office (telemedicine) or bring it with you to your appointment.
Send it back electronically by taking a photo or downloading the Genius Scan App, scan and email it to LHC@LondonHealthCenterInc.com. Please do not put your social security number on the form when sending electronically. Know that sending forms by email is not secure.
Adult (16 years and older) new patient intake form with privacy policy Click Here
Pediatric new patient intake form with privacy Policy Click Here
Acupuncture intake Forms Click Here
Massage intake Forms Click Here
Covid-19 Informed Consent Form Click Here
Medicaid: Non-covered services form Click Here
Medicare: Advance Beneficiary Notice of Non-coverage Click Here
Kaiser: Non-covered services form Click Here
How do I check my insurance benefits? Click Here
Sliding Fee Application Click Here
Parent's link to child's immunization record Click Here
Patient Election to Self Pay Form Click Here
Records Request Form Click Here