Please note our practice
requirements !
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Practice
Policy Payment:
Payment is required at the TIME OF YOUR VISIT. We accept Cash, Check, Mastercard or VISA. If you have
insurance you MUST present your insurance card at the time of your visit. Please notify the office of any
address, phone number or insurance changes. Any Co-Payments are due at the TIME OF YOUR
VISIT. There will be a service charge of $25.00 on all returned checks.

"There will also be a $25.00 charge for all
No Call/No Show
appointments
that are not cancelled 24 hours in advance of appointment time."
Prescriptions:
Prescriptions should be renewed Monday through Friday. 48 hour advance notice is required for
phone-in/fax prescription renewals. Please do not call for renewal after office hours or on weekends.
Renewals of all triplicate prescriptions require periodic office visits to monitor your progress and
prescription use.
Forms:
Please allow for up to 5 working days for completion of your medical forms.
Depending on the complexity of the forms, we reserve the right to charge
for the completion.
Medical Records:
Due to the rising costs in operating our medical practice, there will be a
$20.00 charge to copy and mail your medical records. Upon payment and receipt of a properly signed authorization, your records will be
transferred within 10 business days.
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