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patient transfer evaluation information

Please provide the following information:

* Note: Your credit card will be charge only after appointment confirmation.


We strive to deliver the best possible service to our patients. If you wish to cancel up to 48-hours prior to your appointment you will not be charged a fee. We require a minimum of 48-hours cancellation notice for all appointments. There is a 100% ($125.00) fee that will be charged to your card for no-shows / cancellations without a 48-hour notice.


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