Please use the links below to fill out our HIPAA complaint medical questionnaire & Financial Forms:
The deposit and a signed financial agreement are due immediately to schedule a DATE. No exceptions.
Please use these links to pay for the $800.00 deposit:
Click here to pay by credit card
Click here to pay by checking account
The deposit is refundable until 2 weeks prior to the procedure.
Please fill out the medical form below:
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