TERMS

1) Arrivals
a) If this is your first time visiting our clinic, please arrive early to fill out a health history form. (It is also available for download on our website).
b) Please arrive on time for your appointment. A late arrival will require that we end the treatment at the scheduled time so that the rest of our appointments are not affected. Thank you for understanding.

2) Payments a) Payment is due at the time of service. We accept Cash, Debit, Visa/Mastercard and eTransfer.
b) As a convenience to you this office is able to provide direct billing for many insurance companies.
In cases where there is not 100% coverage, or a claim is rejected/disputed, or there is no explanation of benefits provided, the patient will be required to pay the fee for treatment.
Please bring a backup form of payment in case we are unable to process your claim.
c) A receipt will be provided for you to submit for reimbursement from the insurance company.

3) Rescheduling and Cancellations
a) We reserve your appointment time just for you. Please provide at least 24 hours notice if you need to reschedule or cancel. This will allow us to offer your appointment to someone on our wait list.
b) Failure to provide adequate notice will result in a missed appointment fee that is equal to the cost of the treatment booked. We request payment in full within 30 days, or before your next treatment.
i) Sometimes we may experience a technical glitch with our reminder system. If you fail to receive a reminder text or email, we will not consider this a valid excuse. Missed appointment fees will apply.
c) Any future bookings will be canceled until your account balance has been settled.
d) Missed appointment fees CAN NOT be billed to your insurance company.

4) Gift Certificates
a) Gift Certificates are available for purchase from the office. Please call to arrange a time to pick up.
b) The gift certificate will be forfeited/applied towards the cancellation fee in cases where there is a late cancellation or no show. (No exceptions).
c) There are NO REFUNDS on gift certificates, however if the recipient does not want to use the certificate themselves, transferring to someone else who will use it is highly encouraged.

5) Miscellaneous
a) As a courtesy to all our clients, please turn all cell phones to silent mode while in the office.
b) Please refrain from wearing/using any products that are heavily scented during your visit.
c) If you are able, we request that you remove any wet boots and shoes at the front door. This helps to keep the office clean, and will help to prevent any slip and falls from a wet floor.

Thank you for your cooperation.


PRIVACY POLICY

The privacy of your personal information is important to our clinic. We are committed to collecting, using and disclosing personal information responsibly and only to the extent necessary for the goods and services we provide.

Like all medical professionals, we collect, use and disclose personal information in order to serve our patients. The primary purpose for collecting personal information is to provide treatment.

Like most organizations, we also collect, use and disclose information for purposes secondary to our primary purposes. The most common examples of our related and secondary purposes is to invoice patients for goods or services that was not paid for at the time, to process credit card payments or to collect unpaid accounts.

The cost of goods/services provided by the organization to patients is often paid for by third parties (e.g., motor vehicle accident insurance, private insurance). These third-party payers often have the patient's consent or legislative authority to direct us to collect and disclose certain information in order to demonstrate patient entitlement to this funding.

Patients or other individuals we deal with may have questions about our goods or services after they have been received. We retain patient information for a mandatory minimum of ten years after the last contact.


PROTECTING PERSONAL INFORMATION

We understand the importance of protecting personal information. For that reason, we have taken the following steps:

• Paper information is either under supervision or secured in restricted area.
• Electronic hardware is either under supervision or secure in a restricted area at all times.
• Paper information is transmitted through sealed, addressed envelopes or boxes by reputable companies.
• Electronic information is transmitted either through a direct line or has identifiers removed or is encrypted.
• External consultants and agencies with access to personal information must enter into privacy agreements with me.

You can access your information

With only a few exceptions, you have the right to see what personal information we hold about you. We can help you identify what records we might have about you. We will also try to help you understand any information you do not understand (e.g., short forms, technical language, etc.). We reserve the right to charge a nominal fee for such requests.









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519.602.5562    •    795 Dundas St., Woodstock ON