Providers, to refer a new patient, please fax us this Refer a Patient Form.
Please print and bring completed “required” forms with you to your 1st appointment.
Policies Demographic Insurance ROI (required)
Insurance Financial Agreement (required)
Assumption Of Risk (required to leave office for walking visit or experientials)
Credit Card/HSA Card Authorization (required for copays and balance)
Phone: 888-PHR-4ALL (888-747-4255)
Copays are due at the time of your appointment. We accept cash, check, Visa or MasterCard.
We Accept The Following Insurance. Please confirm your medical plan coverage with your insurance provider; “In-network status does not guarantee plan coverage for nutritional therapy.”
United Healthcare (most plans)