972.444.0660 
New AIMC Patient Intake Forms & Insurance Information
We’re excited to welcome you to the Acupuncture & Integrative Medical Center family! To make your first visit as smooth and stress-free as possible, we provide our intake forms online. By completing these ahead of time, you’ll save valuable time during your appointment, while also giving our team a clearer picture of your health history, lifestyle, and unique concerns. This helps us personalize your care from day one and ensure you receive the most effective treatment plan for your needs.
New Patient Forms
Insurance We Accept
We are in-network with Blue Cross Blue Shield, United Health Care and some Policies with Aetna and Humana. We accept may insurance companies, however each policy is different. We recommend you contact your Insurance company to find out your specific coverage, we are more than happy to contact them together during your first consultation.
Next Steps - Intake Forms
- ① 📄 Download Forms: Choose English or Spanish intake forms.
- ② ✍️ Fill Them Out: Complete your medical history and consent forms.
- ③ 📧 Send Them Back: Email them to info@drchapa.com or bring them with you.
- ④ 🤝 First Visit: Meet your practitioner and start your personalized treatment plan.
Feel Like Yourself Again! – Book Your Appointment Now!
AIMC IRVING
1320 W Walnut Hill Ln
Irving, Texas 75038