This form is for initial consultations. Understand that by submitting this form and paying the deposit you are making an agreement with Dr. Marizelle Arce and Natural Care of Westchester, as well as understand that you are testifying that you have discussed the details of making an appoinment with Dr. Arce prior to the filing of this form.
Appointment cancellations should be made at least 24 hours prior to the appointment. You will be billed [$50 for follow-up visits; $100 for initial visits or exams] for the time scheduled if you do not appear and did not cancel 24 hours prior. Severe extenuating circumstances will be taken into consideration. Late appearances beyond 20 minutes without contacting us are considered no show.
This deposit of $100 dollars will go towards your first appointment. It is NON-REFUNDABLE if cancellations on done after the 24hr period of the appointment time. If you do not abide by the rules mentioned in the paragraph above, you will not have this deposit returned to you. Thank you.
By pressing "SUBMIT" you agree to the above.