Disclaimer:
Intentional Health, LLC works as a medical consultant to supplement care provided by your primary health care team. All patients must have a primary care provider to cover emergencies, routine care, screenings and overall care coordination. We would be happy to collaborate with your primary care provider about your care with your permission.
Emergency Care:
Our office does not administer emergency medical care. In the case of an emergency, please go to your closest emergency department or urgent care.
Confirmation and Cancellation of Appointments
We require a minimum of 48 hours notice through the patient portal for appointment rescheduling or cancellation. A late cancellation or missed visit leaves that time unavailable for other patients. If you do not cancel within 48 hours, you will be charged a $100 no show/late fee to the credit card on file. Notification of Monday appointment cancellations must be received by Friday at 5pm. This applies to new patient visits and follow up visits.
Payment Options
Our office accepts cash, checks or credit cards (MasterCard, Visa, Discover, American Express) for services rendered. When you schedule an initial visit, we require a credit card on file to hold the appointment for you. No charges will be applied to your credit card unless you miss (no-show) or cancel an appointment without proper notice (48 hours). Payment is due on the day of service.
Insurance Information
Services are strictly on a self-pay basis. We do not submit medical claims on your behalf, as we are out of network from all insurances. Please note that there may be treatment recommendations and laboratory tests that are non-covered due to your individual policy/plan type.
I agree to pay for services rendered at the time of service. I acknowledge that I may request the fees for various procedures before they occur.
I consent to treatment as agreed upon between the provider and myself. I agree to discuss any problems in my care with the provider.
I understand that I have the right to refuse any procedure or treatment.
I understand that I have the right to discuss all medical treatments with my provider.
I have read and understand the policies of Intentional Health, LLC. I agree to comply with the policies as stated.