New Patient Scheduling Form
Please fill our scheduling form and we will contact you within one business day with appointment options. Patients ages 18 and over must schedule their own appointments unless they are unable in which case their legal guardian may schedule. We see patients ages 11 and up.
If you have questions before scheduling, please request more information here.
- A $300 deposit is due at the time of scheduling a New Patient Appointment.
- There is a $25 fee for all refunded deposits. There is not a fee for rescheduled New Patient Appointments as long as 2 business days' notice is provided.
- We are out-of-network which means we do not accept any insurance plans. Patients with insurance only can submit for reimbursement for their visits. Patients with Medicare or Medicaid (even if it is secondary) cannot submit for reimbursement.
- We have a 2 business day cancellation policy. There is a fee for appointments cancelled with less than 2 days' notice excluding the Free 20 Minute Cosultation.
ONLY FILL OUT THIS FORM ONE TIME. After that, simply contact us on the portal or email email@example.com to schedule.
If you schedule a Free 20 Minute Consultation, please let us know if you no longer wish to keep your appointment so we can offer it to someone else in need of care. Our providers set aside time in their schedule for each consultation. If you need to cancel a paid appointment, please see our financial policy.
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