New Client Information
Questions about your insurance coverage? Complete this New Client Information form to verify your benefits.[gravityform id=”2″ title=”false” description=”false”]
It is in your best interest to know and understand what your insurance plan benefits are and determine what your financial responsibility is prior to receiving services. Information we obtain from your insurance company is not a guarantee of benefits.
Insurance payment will be determined at the time the claim is processed. You are responsible or any unpaid or denied portion of the claim.