Patient Info & Forms
Welcome – we look forward to meeting you. In preparation for your first appointment, please print and fill out the following forms and bring them with you to your appointment.
Intake Forms for All Patients (CLICK HERE TO DOWNLOAD THESE 3 FORMS):
Patient History
Consent Form
Financial Policy / HIPAA Form
Please Note, we do not contract with any insurance providers.
We are a small, fee-for-service center. In order to provide one-to-one, high-quality care, we are out of network with all insurance including Medicare and Medicaid.
We accept Visa and MasterCard — upon booking your appointment, you will be asked to securely enter your credit card information for your convenience. Your card will automatically be charged after your appointment is completed.
Appointments not kept or canceled without 24 hours notice prior to the scheduled appointment time will be charged a $150.00 cancellation fee.
