You will be asked to fill out the following information on our online intake form
Date of birth
If you are not the insured member, we need the first and last name of the insured member.
*Not all plans allow for direct billing, if your claim needs further processing you will be required to pay for your treatment. We will provide you with a receipt for manual submission.
*If your plan does not cover 100% of the treatment cost you will be required to pay the balance.
*We require a credit card number to store securely in the case that your billing doesn’t go through. If this is the case you would be notified prior to being charged.
*For further information call 403-675-7778 or email firstname.lastname@example.org
Click on the link below to book online.