Payment Policy

Payment in full is due at the time services are render. We accept cash, personal checks, and credit cards. We accept all major credit/debit cards. The fee processing is currently handled through Stripe, a secure payment platform. We will require a credit/debit card to be on file and the card will be charged as agreed. *

I agree

We request the courtesy of 24 hours advance notice if you need to cancel or change your appointment. If you do not show up for your scheduled appointment, and you have not notified us at least 24 hours in advance, you will be required to pay the full cost of the session. Please understand that we do not overbook our schedule. Though we cannot always predict how ill a patient may be or how much time a particular visit may warrant, we do our best to allow the appropriate amount of time in our schedule for you when you make an appointment. *

I agree

Urgent Care Visits are visits that are worked-in / added on when our schedule is already full for that day. *

I agree

I hereby acknowledge that I have been given a copy and reviewed and agreed to the Privacy Practices of Lifestyle Medicine Options: I have read, understand, and agree to abide by all of the above stated policies. *

I agree

Patient Name (or Responsible party if not patient) *

First Name

Last Name

Signature Date *

Lifestyle Medicine Options does not accept insurance. This allows us to provide the type of care we feel you need without the undue influence of a third party. This minimizes our overhead and keeps down paperwork and costs. Debit and credit cards, cash and personal checks are accepted. *there will be a 3% added to each credit card transaction. No % will be added to debit card transactions.

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