PATIENT EXPECTATIONS - I understand that the fee for my first visit may be included in the plan or package I agree to. I understand that the family is defined at Nxt Lvl Chiropractic as the head of household and legal dependents. I agree that if I decline to accept doctor recommendations for care or if the doctor finds an issue contraindicating the chiropractic adjustment, I may still be responsible for that first visit’s charge.
I understand that no potential Patient will be adjusted without a completed history and assessment and that if imaging is warranted, no manual adjustments will be performed until imaging has been reviewed, whether it be imaging ordered at Nxt Lvl Chiropractic or imaging completed prior to the first visit at this office.
I understand following the 1st visit that I/we may come in anytime during Open Adjusting Hours to be adjusted at least once per week; twice per week is better.
I understand that Nxt Lvl Chiropractic is out of network with ALL health insurance companies. I understand that the fees at Nxt Lvl Chiropractic as detailed above are not considered reasonable or customary by insurance companies and that our services are not eligible for reimbursement, however, some Health Savings Accounts (HSA) and Flex-spending accounts (FSA) may provide reimbursement and I understand that such reimbursement requests are my responsibility. I understand that insurance does not cover wellness or maintenance care.
I / We agree to notify Nxt Lvl Chiropractic’s staff of any changes to health status following the first visit.
I understand that auto-debit payments are required if I participate in the Membership Program and that 30 days written notice will be required to stop the auto-debit.
I / We understand that chiropractic care is not about the relief of pain but that it is about balancing the brain, improving the function of my body within the limitations of matter and that many experience the side effect of pain relief from chiropractic care.