For Clients

Information and paperwork for your visit

First Time With Us?

Request your complimentary 15-minute phone consultation.

If you have any questions about your health concerns and what modality or combination of modalities might work best for you, schedule a complimentary 15-minute phone call with us! Come to your first appointment feeling confident in your choice, and with as much understanding as possible about what to expect.

Information for Patients

Required Patient Forms

We require all our clients to complete several forms in connection with your first visit, whether for acupuncture, herbal medicine, NAET, or energy medicine (including Reiki).

All of the forms, with the exception of the Women’s Health Questionnaire, are to be submitted electronically using the links in the automated reminder email you receive from our scheduling system prior to your appointment.

For your reference, we have provided downloadable versions of all forms here. If for any reason you are unable to complete the forms electronically, you may download and submit these electronically (scanned or photographed), or, if  your appointment is in-person, bring the completed forms with you.

Policies and Procedures for Patients

Payments and Insurance

Payment is due at the time of treatment. CCHW accepts cash, checks, and all credit cards including FSA/HSA cards. We are happy to provide an itemized bill for submission to your insurance company.

First-time clients may be asked to secure your appointment by providing credit card information that CCHW will keep on file.  You will not be required to pay using that card at the time of services. You will be contacted prior to any charges being placed on your card due to our late cancellation policy.

Cancellations

Please make cancellations in advance by at least 24 hours or one full business day – that means Friday if the appointment is scheduled for Monday.  Late cancellations (less than 1 business day notice) and missed appointments will be charged for the total amount of the scheduled services.  Emergencies and illness are taken into consideration. If you are unable to reach us directly by phone please leave a message on the voicemail system, which is time stamped.    

Running Late to Appointment

If you are running late to your appointment, please let us know immediately.  In many cases we can accommodate up to 15 minutes late. In this event, you will be seen only for the remainder of your appointment time. Please call us first to ensure there is still time for you to benefit from your treatment.  In the event we need to reschedule, you will be charged the late cancellation fee.

Feeling Sick

If you are sick or starting to feel sick contact us immediately to reschedule your appointment. Late cancellation fees will not be incurred for such cancellations. There are a number of low immune patients in our practice for whom any kind of illness can become serious.

Preparing for Your Visit

Initial appointments

All first-time clients will be asked to fill out an intake form and sign a consent form.

Lab work

You are invited to bring in any lab work that you may have to your first acupuncture or NAET treatment. The data from lab work helps us to track your progress, and can provide tangible evidence to the medical community on the benefits of NAET and acupuncture.

Note that NAET patients are required to provide specific lab work as detailed on our NAET webpage.

For more about what to expect at an appointment…

… please refer to the webpage for the specific service.

COVID-19 Safety Measures

Updated June 22, 2022 | Printer-friendly version

Our existing safety procedures mostly remain the same. Some of our clients have immune system impairments which put them at higher risk of serious illness from COVID-19. Thank you in advance for helping us minimize the risks for everyone.

We continue to adapt our policies and procedures as circumstances change. The following is a detailed but not exhaustive list of our current procedures.

General Clinic Procedures

  • Enhanced practices for cleaning and disinfecting
  • Social distancing practiced except as required for treatment

Procedures for Patients

  • If you feel sick, please reschedule your appointment. This applies to any potentially infectious illness, not just COVID-19. No penalty for late cancellation.
  • If you have been exposed to COVID-19, please contact us as soon as you know about the exposure and before coming in for your next appointment. Please refer to CDC guidance, which defines exposure and gives recommended precautions to take after being exposed.
  • If you test positive for COVID-19 within 10 days prior to your appointment, please contact us immediately before coming in. Decisions about rescheduling will be based on current CDC and/or local health department guidance.
  • Waiting room capacity is limited.
  • You must wear a mask to the appointment, even if you are fully vaccinated. Nose and mouth must be completely covered. It is required to wear your mask for the entire time in the office. A mask with a vent or valve is not permitted.
  • Hand sanitizer and sinks are available for hand-washing.
  • At the beginning of your appointment, you will be asked about symptoms, and whether you have recently had exposure to or tested positive for COVID-19.

Procedures for Staff

  • Same screening criteria as patients prior to each workday.
  • Social distancing except as required for treatment.
  • Wear mask at all times.
  • Wash hands frequently throughout the day as well as before and after each treatment.
  • Wear gloves when necessary.
  • Wipe down surfaces with increased frequency.

These safety policies and procedures have been developed in accordance with guidelines from the Illinois Society of Acupuncturists, the American Society of Acupuncturists, and the Council of Colleges of Acupuncture and Oriental Medicine (CCAOM Advisory April 30, 2020).

In addition, we monitor information from the Centers for Disease Control and other healthcare organizations regarding best practices as they evolve over time. We also monitor and adhere to all relevant governmental laws and guidelines for COVID-19, including those in Illinois and Chicago.

Revision History

  • October 26, 2020: Inclusion of procedures for community-related exposure to COVID-19. Inclusion of procedures concerning the Chicago Emergency Travel Order
  • May 5, 2021: Minor changes to reflect changes in public health guidance, and to improve clarity.
  • January 21, 2022: Minor changes to reflect changes in public health guidance.
  • June 22, 2022: Elimination of pre-visit screening form. Changes reflecting current CDC and local public health guidance and practices.

Request an Appointment

Calandra Center for Health & Wellness offers a safe place to cultivate well-being and heal the mind, body, and soul. We work with you and your other healthcare providers to help create a fully integrative healthcare experience.

Request an Appointment