(new clients must complete prior to scheduling initial visit)
(new clients must complete prior to scheduling initial visit. Please note this will NOT be automatically charged- it is kept on file for no-show fees, etc)
Per clinic policy, we will keep a credit card on file for all patients and will charge 50% of the cash price for any no-show visit or for any visits that must be rescheduled due to patient tardiness of more than 5 minutes from the scheduled visit start time. For initial visits for cash patients- there is a non-refundable 50% of the initial visit fee upon scheduling in order to reserve the appointment time. This fee will be credited towards the cost of the visit at time of service. All personal information will not be shared and will be stored in a HIPPA compliant database. Financial information will be saved for future transactions on each account and patient must agree to be billed any outstanding fees directly to the card on file.