Dresden Holden Wellness: office policies
If you need to reschedule or cancel your appointment, please give at least 48 hours notice, otherwise we reserve the right to charge a fee depending on the service. You may use the patient portal to manage your appointments, including rescheduling and cancelling them.
Missed appointment fees
$225.00 for Initial Acupuncture, $165.00 for Facial Rejuvenation Acupuncture, $165.00 for Acupuncture Follow-up, $100.00 for Cupping Session, $325.00 for Home Visit Acupuncture, $225.00 for Initial Fertility Acupuncture, $180.00 for Initial Telehealth / Herbal Consult, $130.00 for Telehealth / Herbal Consult Follow-up, $225.00 for Microneedling with Botanical Serums, $225.00 for Microneedling with Procell Growth Factors
If you need to reschedule or cancel your appointment we require 48 hours notice. We do reserve the right to charge a fee for appointment cancellations within 48 hours of your scheduled appointment.
- Within 48 hours - $165 charge (Fees change according to appointment type.)
- NO CALL / NO SHOW - $165 (Fees change according to appointment type.)
Cash, check, credit cards are all valid forms of payment.
If your check is returned by the bank, we will notify you and charge you for non-payment. You must pay in cash or with credit card for the full amount owed, plus a $50 returned check fee.
Regular In-office Hours: Thursday, Friday, Saturday.
There are times when there is a need for after-hours communication. Practitioners are available to address email and phone requests during regular office hours (between 10am-4pm on weekdays). Please allow 24-48 hours for response. If a practitioner is unavailable to be reached an out-of-office notice will be sent.
The following emails and phone calls between scheduled appointments, will be charged a prorated rate based on the hourly rate of $165.
*Acute issues that come up between appointments
*Herbal formula review and/or refill
*Multiple questions in one email
*Reading medical records
*Interpreting lab results
*Needing additional information regarding existing issues being addressed at our appointments
*Requests for reading articles/research on an aspect of your health concern
*Requests on general or specific opinions on any number of health topics
*Recommendations for friends or family members who are not part of the practice
*Questions regarding lab testing protocols (Generally, these can be answered by the lab.)
This charge can be run on the credit card provided or added to your next visit.
All are welcome and this is a working clinic, it is our request that you be quiet in shared spaces (i.e. the waiting room) as other patients may be receiving treatment.
We are still mindful of Covid-19 protocols and procedures. Masks will be available for you in the waiting room should you choose to wear one.
First visit preparation
Please establish a Patient Portal account, fill out New Patient paperwork and sign office policies prior to your visit and show-up a few minutes early to your first appointment. If you would like to fill out paperwork and policies in office please let us know prior to your visit. It is advised to wear comfortable loose fitting clothing, have at least a little food in your system to mitigate low blood sugar, and have some water ready for post-treatment.
Plan ahead to allow some time to rest after your visit. Keep rigorous exercise and the use of alcohol to a minimum for a couple hours post-treatment.
Your right to privacy in this medical practice is paramount and personal information will not be disclosed without your express consent, unless required to do so by law.
Informed consent treatment
By signing below, I (the patient) do voluntarily consent to be treated with the procedures mentioned below by Dresden Holden Wellness. I understand that receiving regular primary care by a licensed physician is an important choice that is strongly encouraged by Dresden Holden Wellness.
I understand that acupuncture is performed by the insertion of needles through the skin and moxibustion is performed by the application of heat to the skin at certain points on or near the surface of the body in an attempt to treat bodily dysfunction or diseases, to modify pain perception, and to normalize the body's physiological functions. I am aware that certain adverse side effects may result. These could include, but are not limited to: local bruising or redness, minor bleeding, fainting, pain or discomfort, and the possible aggrevation of symptoms existing prior to acupuncture treatment. I understand that no guarantees concerning its use and effects are given to me and that I am free to stop acupuncture treatment at any time. The staff at Dresden Holden Wellness has informed me that this clinic uses stainless steel disposable needles and maintains a clean and safe environment.
In this unique style of acupuncture adjuct therapies are often utilized in any given treatment to maximize potential benefits of treatment. These adjuct therapies are listed in the treatment menu and may encure a charge greater than the base follow-up acupuncture fee.
I understand that warm therapy called moxibustion is a modality used in TCM. Moxibustion (or moxa) employs mugwort to gently warm the skin for therapeutic effects. This will create a local warming effect. We utilize indirect moxa at this office.
I understand that the use of cupping commonly produces temporary petechiae, redness or bruising that may last several days. I understand that I may refuse this therapy if it is offered to me.
Red LED / Infrared Light Therapy
I understand that red light therapy is a modality used to treat fertility, pain, circulation, facial rejuvenation, skin disorders, depression, anxiety, hormone health, as well as a muriad of other things. Infrared will create a local warming effect. While red light therapy is found to be quite safe, goggles will be provided to shield the light during use.
Tui na / Bodywork / Manual Therapy / Acupressure
I understand that I may also be offered tui-na massage/bodywork/manual therapy/acupressure as part of my treatment to modify pain perception and to normalize the body's physiological functions. I am aware that certain adverse side effects may result from this treatment. These could include, but are not limited to: bruising, sore muscles or aches, and the possible aggrevation of symptoms existing prior to treatment. I understand that I may stop the treatment at any time if I choose to do so.
Energywork / Reiki
I understand that I may also be offered energywork/Reiki as part of my treatment to modify treatment. I understand that I may stop the treatment at any time if I choose to do so.
I understand that I may be asked to have electro-acupuncture administered with the acupuncture. I am aware that certain adverse side effects may result. These may include, but are not limited to: electrical shock. Pain and discomtort, and the possible aggrevation of symptoms existing prior to treatment. I understand that I may refuse this treatment and will notify my practitioner if I have or received an electronic device implantation such as a pacemaker while under their care.
Microneedling & Cosmetic Acupuncture
Microneedling, also known as collagen induction therapy, is a minimally invasive, non-surgical, non-ablative procedure for facial rejuvenation. This therapy involves the use of a microneedling device; as each fine needle punctures the skin, it creates a superficial micro-wound to the outermost layer of the skin, inducing the healing process including new collagen production. Because micro-needling penetrates the skin, it inherently carries health risks, including but not limited to those listed below. You should discuss any and all health concerns with your esthetician or attending healthcare provider PRIOR to signing this consent form.
Due to the nature of the procedure, micro-needling may cause infection, pigment/color change, scarring, pain, redness, itching, and/or swelling, and/or an allergic reaction. After the procedure, the skin can be red with mild swelling and/or bruising and might feel tight and sensitive to the touch. Although these symptoms may take 2-3 days to resolve completely, they will diminish significantly within a few hours after treatment.
There are certain contraindications for micro-needling treatments: active acne, active infection of any type (bacterial, viral, or fungal), cardiac disease/abnormalities, collagen vascular disease, eczema, psoriasis, or dermatitis, hemophilia/ bleeding disorders, keloid/hypertrophic scaring, pregnancy/lactation, raised lesions (moles, warts, etc.), skin cancer, sunburn, tattoos, telangiectasia/erythema, uncontrolled diabetes, vascular lesions (hemangiomas), rosacea, and scleroderma.
The use of Botox®, Juvederm®, Restylane®, and any other injectable must be disclosed prior to treatment.
Contraindicated medications: blood thinner medications, chemotherapy or radiation, hormone replacement therapy, recent use of some topical medication.
Micro-needling is contraindicated within 72 hours of waxing, and within 1-3 weeks of a chemical peel.
While the goal of this treatment is to improve the vitality of the skin, no specific guarantees of the result can or have been made.
I understand that herbal substances may be prescribed to me to treat bodily dysfunction or disease, to modify pain perception, and to normalize the body's physiological functions. I understand that I am not required to take these substances but must follow the directions for administration and dosage if I do decide to take them. I am aware that certain adverse side effect may result from taking these substances. These could include, but are not limited to: changes in bowel movement, abdominal pain or discomfort, and the possible aggravation of symptoms existing prior to herbal treatment. Should I experience any problems, which I associate with these substances, I should suspend taking them and contact my practitioner as soon as possible.
The cost of herbal medicines are not included in the treatment price.
Other informed consent treatment
I will notify my practitioner should I become pregnant or if I am in the process of trying to get pregnant while under their care so they may avoid acupuncture points and herbal formulas that could have adverse effects to pregnancy. Otherwise, my practitioner has informed me that Chinese Medicine can be very beneficial in the trying to conceive, pregnancy, birthing and postpartum process.
Your right to privacy in this medical practice is paramount and I will never disclose any of your personal information without your express consent, unless required to do so by law.
This notice describes my office's policy for how medical information about you may be used and disclosed, how you can get access to this information, and how your privacy is beina protected. Please read it carefully.
Dresden Holden Wellness practitioners will acquire private information about their patients. This is confidential and will not be discussed outside the office, except that Dresden Holden Wellness practitioners may discuss patients with other health care professionals in terms that do not allow identification of the individual.
Your protected health information, including your clinical records, may be disclosed to another health care provider or hospital if it is necessary to refer you for further diagnosis, assessment, or treatment.
Your health care records, as well as our billing records, may be disclosed to another party, such as an insurance carrier, or your employer if they are or may be responsible for payment or services provided to you.
Your name. address, phone number, and our health care records may be used to contact you regarding appointment reminders, information about alternatives to your present care, or other health related information that may be of interest to you. It you are not home to receive an appointment reminder or other related information, a message may be left on your voice mail / answering machine or with a person in your household. You have a right to contidential communications and to request restrictions relative to such contacts, or contact by alternative means.
Additionally, we may be required to disclose your health information in the following circumstances: in the event of an emergency: if required by law; if there are substantial barriers to communicating with you, but in our professional judgement we believe that you intend for us to provide care; if ordered by the courts, government authorities, public health, law enforcement, coroners, or funeral directors; in the event of organ donations, research military activity, or for national security.
Patients have the right to receive an accounting or any such disclosures made by my office.
Any use or disclosure of your protected health information, other than as outlined above, will only be made upon you written authorization.
If you would like copies of your records, you must submit a written request for copies or medical records at least 5 business days in advance. The charge for copying records is 30 cents per page, with a $15 minimum charge.
Any complaints about these policies or requests for further information may be directed to Dresden Holden L.Ac. of Dresden Holden Wellness. Best reached at email@example.com or (805) 395-6808
We do not accept health insurance directly, but we can provide you with a coded superbill that you (the patient) can submit to your insurance for reimbursement. You should be able to contact your insurance prior to treatment to confirm their coverage of acupuncture and what they cover acupuncture for.
If you need coded receipts please request them at time of initial service. Coded superbills can be accessed and downloaded at the patient's convenience in the Patient Portal.
Please note practitioners will not contact an insurance company directly.