NEW PATIENT INSTRUCTIONS
We are accepting new patients 18 and up. At times, we have a short waitlist. We will use the following form information to add you to the list if needed.
Steps to Making a New Patient Appointment:
- Please complete the new patient form below. This is very important; all new patients must have this completed PRIOR to being seen.
- If you are using insurance, we will confirm your insurance benefits PRIOR to our first meeting. This process typically takes two business days. If we are out-of-network and you would like to use your out-of-network benefits, after you have self-paid, we will provide you with a receipt that you can use to apply for reimbursement. If this form is not completed at least 24 hours prior to your first appointment, the appointment will be canceled.
**This form does not replace the new patient paperwork. This is for insurance verification and chart creation only.
If we believe another practitioner might be better suited for your treatment needs, we will help you with a referral.
Do not hesitate to call or text us if you have any questions.
If this practice is not in your insurance network, you can self-pay and apply to your insurance for out of network benefits.
Please note that once you have self-paid for a visit, we do not retroactively submit the visit to insurance. Please alert us ahead of your visit if you ever need to change your method of payment.
Office fees for self-pay patients are $125 ($150 for the first visit). Payment is due at the time of service. There is a $65 fee for no-shows and less than 24-hour notice of cancellation.
No refunds are given after a service has been rendered per appointment policy.
We take cash, check, credit/debit cards, and HSA/FSA cards.