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WELCOME

We are currently accepting cash-only patients, with new appointments available starting June 1, 2025.                                                                             If you would like to begin your care with us, please complete the following form. We will reach out to you to initiate the intake paperwork.            

 

INTAKE PAPERWORK must be COMPLETED first, then REVIEWED before an appointment can be scheduled.                                                                                  

Thank you for your interest!

New Cash Patient Request

Please submit the following if you wish to REQUEST

to be seen as a new patient**:

Method of Payment for Services Required
Upload File
Upload supported file (Max 15MB)

 

Please be aware that this does not establish a patient provider relationship or guarantee care.

Appointments are not made until there is a credit or debit card on file for patient payment responsibility

(co-payment, co-insurance, no call no show fee, etc.),

AND

intake paperwork is completed and reviewed.

Thank you for contacting us!

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