INTEGRATIVE CHIROPRACTICOFFICE POLICY 2016-2017


Please print, complete this form and bring it with you for your first appointment.

1. SERVICES WILL BE PAID FOR PRIOR TO TREATMENT, X-RAYS OR EXAMINATIONS. THE ONLY EXCEPTIONS ARE PATIENTS THAT ARE ON A CAREPLAN, PAID IN ADVANCE OR HAVE MADE OTHER ARRANGEMENTS (PERSONAL INJURY) 



2. SCHEDULED APPOINTMENTSTHAT ARE NOT CANCELLED OR RESCHEDULED AT LEAST 24 HOURS IN ADVANCE WILL INCUR A $25 CHARGE THAT MUST BE PAID PRIOR TO NEXT SCHEDULED TREATMENT.