Appointment Request
NEW PATIENT DEPOSIT POLICY
A $35 deposit is Required to secure your New Patient Appointment.
This Deposit is a Placeholder for your first Visit. It may be paid over the phone by debit or credit card, or in person using debit, credit, or cash.
By paying a deposit, you agree that your appointment with the doctor is important and you agree to the following:
Your Deposit will be applied to your first day charges (Copay or coinsurance for insurance patients.)
If a change is made to your New Patient Appointment:
- With more than 24 hours notice, The deposit is refunded or forwarded to the new appointment time.
- With less than 24 hours notice, the deposit is forfeited.
- If you miss your appointment (no show/no call) you forfeit your deposit.
**NEW PATIENT Appointments will only be scheduled up to 7 days in advance.**