Please note, our treatments are not covered by insurance. Please include any additional information about your request in the Reason For Visit box below. This form is for requesting an appointment and will only be booked once we get in touch with you to setup a date and time for your office visit. There will be a $150 non-refundable deposit to book appointment and forfeited for no-shows and cancellations less than 2 business days prior to the scheduled appointment.
