Patient Forms

Please download and complete the appropriate form(s) below, under your provider’s name, and bring to your first appointment.


We accept Moda, Providence, BCBS, and United insurances for acupuncture.  Benefits vary by plan, please call our office to verify insurance plan participation at 503-297-3825.


Chikako Harper, N.D., L.M.T.

Submit insurance information:  Please click on the button below to be directed to the company that provides insurance billing for Dr. Chikako. This helps process insurance claims efficiently and accurately.   Please do this before your first visit.

Petra Caruso, N.D.

Yarley Nystrom, L.M.T.

Phone: 503-297-3825


‚Äč© Jade River Healing Arts Center Copyright 2018