Financial Consent
By clicking, you acknowledge and agree to the following financial responsibilities:
Payment to Partner Providers: You agree to pay all fees associated with the treatments to our partner providers. This includes but is not limited to, consultation fees, treatment fees, and any other costs that may arise during the course of treatment.
Medicare and Insurance Non-Coverage: You understand that Medicare and insurance coverage will not apply to these services. You are solely responsible for the payment of all fees, irrespective of any Medicare or insurance coverage.
Pre-Service Payment: Payment to our partner providers is always required before services are provided. Failure to make payment in advance may result in the withholding or postponement of scheduled services.
Cancellation Policy: If you need to cancel or reschedule an appointment or service, you must provide notice 48 hours in advance. Failure to do so may result in a cancellation fee.
E-Signature and Consent Acknowledgment: By clicking, you confirm that you have read, understood, and consent to the terms listed above. Clicking acts as your electronic signature, which carries the same legal weight as a handwritten signature.