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The following forms will provide BALANCE with important information to begin treatment. All information you provide in completing the forms and during sessions will be kept strictly confidential in accordance with state and federal law.


If you are being referred by another healthcare practitioner, please complete this Consent to Release Information.

Please bring these completed forms with you during your initial visit.





Counseling Consultation (45-60 minutes):$95

Orthopedic Massage/Medical Qigong (45-60 minutes):$70

Extended Session (75-90 minutes):    $100
(only in clinically-indicated cases of orthopedic massage and medical qigong)

Counseling Consultations and aspects of Integrated Services may be covered by insurance and are also offered on a sliding scale.
SCHEDULING AND PRICING
SCHEDULING AND FORMS
BALANCE Integrative Care, PLLC     910.232.5778     info@balanceintegrativecare.com
PRICING FOR TREATMENT SESSIONS