New Client Form

We would like to take this opportunity to welcome you to our office and assure you that we will do our utmost to provide you with the best care possible. We also would like to explain our financial policy as it relates to your responsibility for the account

Customer hereby acknowledges and agrees that any account that becomes delinquent will be subject to collections service. Customer agrees to pay all court costs and reasonable attorney fees for collection of all past checks, late fees, and additional charges for the cost of collection Late fees will accrue at a rate of 10% of the amount owed every 30 days until the balance is paid or until the account is sent to collections after 6 months of nonpayment. Collection fees will amount to 33% of the principal amount due in addition to the balance owed on the account.

Finally, be assured that we are all here to serve you with the best care possible. When leaving our office, you should leave with the feeling that all your questions have been answered.