Check "self" and/or a first-degree relative who has experienced any of the following conditions:
Please indicate how often you consume the following:
Describe typical food choices and approximate time each day for the following meals:
Check all that apply
We are honored to partner with you in achieving your wellness goals. We recognize and value the trust that you have bestowed upon us. In order to preserve a great relationship with our patients, we're providing the following information concerning how we do business and how we can best provide healthcare services.
Payment Requirements: Payment is expected for all services at the time of service. Your initial appointment will be charged to your credit card the day it is made. We gladly accept all major credit/debit cards.
Insurance information: LivingWell Integrative Healthcare does not bill ANY insurance companies. None of our providers are “preferred providers” for any insurance company. We work for you instead of an insurance company. Our goals are to provide services based on your individual healthcare needs, without a third party intruding on your healthcare choices. We will provide initial assistance in filling out your insurance reimbursement forms (unless you have Medicare or Medicaid, see below). Please be aware that some insurance companies will not reimburse for our fees. If assistance with additional forms is required, there will be a fee for this service.
Medicare/Medicaid please read the following information carefully: All of our providers have “Opted Out” of Medicare. We are NOT Medicare providers and our services are NOT BILLABLE OR REIMBURSABLE TO MEDICARE. Therefore you CANNOT file for reimbursement of any kind.