Book Your Appointment

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Patient Information

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Appointment Details

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Medical Information

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Terms & Conditions

1. Appointment Scheduling and Cancellation

By scheduling an appointment, you agree to arrive at the designated time. If you need to cancel or reschedule, please provide at least 24 hours' notice. Failure to do so may result in a cancellation fee equivalent to 50% of the appointment cost.

2. Payment Terms

Payment is due at the time of service unless prior arrangements have been made. We accept various payment methods including credit cards, debit cards, and electronic payment services.

3. Medical Information and Privacy

You authorize us to collect, use, and disclose your personal health information for the purposes of providing medical care, securing payment, and other healthcare operations. Your information will be kept confidential in accordance with applicable privacy laws.

4. Patient Responsibilities

You are responsible for providing accurate and complete information about your present health conditions, past illnesses, hospitalizations, medications, and other matters relating to your health. You are also responsible for following the treatment plan recommended by healthcare providers.

You must accept the Terms & Conditions to proceed.

Payment Summary

Patient Name:
Appointment Date & Time:
Appointment Fee:
$9.00

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