PATIENT FORMS
SELECT ONE
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We support these plans & payment options:
PPO’s Only, No HMO’s
Blue Shield
BRMS
Chiropractic Health Plan of California
First Health / CCN
International Longshore & Warehouse Union – ILWU
Cash or Check
Zelle
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We understand there are times when you must miss an appointment due to emergencies or obligations for work or family. Please call/text to cancel an appointment at least 24 hours prior to your appointment. There is a charge of $100 for not showing up for scheduled appointments OR for a LATE Cancellation.
Note: this fee will not be covered by your insurance company.
If you do happen to cancel late, but we are able to fill the slot, you will not be charged.
The first offense will be considered a “warning.”
Repeated cancellations or missed appointments will result in loss of future appointment privileges and/or potential dismissal from the practice.