OFFICE POLICIES AND FINANCIAL AGREEMENT
Office Hours and Appointment - We are open Monday, Tuesdays, Thursdays and Fridays (9am-5pm) Elly Tuchler A.P. will do her best to treat and respect each patient’s condition and time.
Insurance - We are not participating providers with any insurance companies at this time. At your request, we can provide you with an insurance reimbursement form that we can fill it out at the end of the service. In addition, it is your responsibility to send the form to your insurance company for your reimbursement. The reimbursement will depend on the plan you have with your insurance company, therefore we cannot guarantee it.
Cancelation and Missed Appointment Policy - - Please help us serve you and others better by keeping your appointments. Your appointment time is reserved exclusively for you; therefore, we require a minimum of 24 hours’ notice (within business hours) when canceling or rescheduling your appointment to avoid a $50 fee, no exceptions. For Individual Systemic Constellation, the fee is $70. We reserve the right to refuse services until fees are paid.
Payment - Payment for services and remedies are due at the time of service, except when other arrangements have been made in writing with our office. In addition, advanced payment can also be arranged at the office. We accept cash, checks, Visa, MasterCard and Discovery Card. All returned checks will be subject to an additional charge of $35.
Fees - The fees charged at this office are comparable to those charged by other specialists with similar qualifications in this geographic area.
Homeopathic Remedies -The costs for Homeopathic remedies are not included with the treatment. Generally, remedies range from $15-$30 depending on the level of potency. In case to order homeopathic remedies, the payment should be made before pickup. The remedies will be prepared specifically for the patient. No refunds will be made under any circumstance.
SERVICE / PRICE
Initial Consultation + Acupuncture Treatment | $115
Follow-up Acupuncture Treatment | $95
Follow-up Homeopathic Treatment | $95
Family Constellation (individual) | $150
This agreement is between Acupuncture & Homeopathy center and the patient. Policy is subject to change without notice. If you understand the terms listed above, please sign at the space below.