You’re welcome to print off and complete the appropriate intake form below and HAVE IT WITH YOU for your first visit if you’d rather do so in advance. We will have the form at the clinic for you to fill out before your treatment but you must arrive 5 – 10 minutes before your appointment time to do so. Please ensure that it has the most accurate & complete information.
Direct Billing to Insurance Form – This form can be filled in electronically and must be emailed to us at [email protected] 24hrs before your first appointment if you’d like us to attempt to bill directly to your extended medical company as we need time to setup your account. Note that we only bill to one insurer per patient and it must be your primary insurance provider. Not all plans allow us to process the charge. (Form will download to your computer – check your Downloads folder)