Wellness care is a very important part of your health plan.  The objective of wellness care is to promote an optimal state of health and wellbeing so that we can live a life full of vigor and joy.  We have several different wellness plans to suit your needs and each one of them includes 10% OFF of supplements and supports as well as 25% OFF of Footleveler Spinal Pelvic Orthotics and $35 wellness adjustments for child dependents living at home, in college or if you need an additional wellness adjustment.

SILVER WELLNESS PLAN: 59.95/month        SAVINGS OF MORE THAN $25/MONTH

  1 Adjustment/month ($50) + 1 thirty minute massage/month ($35)           = $85/month Retail

GOLD WELLNESS PLAN:  99.95/month          SAVINGS OF MORE THAN $75/MONTH

  2 Adjustments/month ($100) + 2 thirty minute massages/month ($70)       = $170/month Retail

PLATINUM  WELLNESS PLAN:  149.95         SAVINGS OF MORE THAN $125/MONTH

  4 Adjustments/month ($200) + 2 thirty minute massages/month ($70)       = $270/month Retail

The Wellness Program enables you to receive wellness (non-symptomatic) chiropractic and massage therapy at a substantially reduced cost. Please note that this special benefit is ONLY available to patients that have successfully completed their corrective plan. Insurance will NOT be billed for wellness care; however, many health care savings accounts and medical savings accounts reimburse for these services.  Receipts will be given on a monthly basis by request only.  The Wellness Program may be placed on hold if you are involved in an accident, injury, or significant exacerbation of your previous condition.  The Wellness Program will begin on the first of the month immediately following the completion of your corrective care plan. Your credit card will be charged a one-time initiation fee of $99plus the amount chosen above.  On or about the first of each month your card will only be charged the amount you chose above.  You may drop out at any time with 30-days written notice; however we strongly encourage you to keep up your excellent progress throughout your life! Due to the substantial discount being offered, no fees paid in part or in whole are refundable. We reserve the right to decline continued participation at any time during the course of the program due to excessive cancellations, missed appointments or other unforeseen reasons. In the unlikely event that you have to reschedule any appointment, please provide us with at least 48 hours notice when possible.  No-shows and cancellations less than 24 hours in advance count as a massage or adjustment respectively.  There is never any obligation to continue and you can drop out at any time; however, please be aware that the $99 initiation fee may be assessed upon rejoining. 

By my signature below I agree to the terms of this agreement and I agree to use every effort possible on my end to make this program a success. Please print your name, enter the last four digits of your credit card # and the expiration date, sign this form, and then turn it in to the doctor or any staff member. Please ask if you have any questions!

 

I,                                                                                          , hereby agree to the above terms and conditions.

 

Credit Card #: _XXXX-XXXX-XXXX-             Exp:                        /              /             

 

_______________________________________________             Date:                           /              /             

Signature (Required)

_______________________________________________             Date:                           /              /             

Witness