Pre-qualification Questionare

Appointment Checklist

Please bring the following documents to your appointment:

Proof of Identification

  • Current and valid Florida Driver’s License
  • Current and valid Florida ID card
  • Proof of Florida residency such as utility bill, lease, bank statement, etc.

Medical Documentation

  • Recent medical records
  • List of current prescriptions (if any)
  • Physician’s letter (optional)
  • X-rays, MRI’s or other test results (if applicable)

Payment Method

  • Check, credit card, online payment, or money order

Other Requirements

  • If you are under age 18, you must be accompanied by a parent or legal guardian
  • You must not currently be on legal probation
  • There is a $99.00 Fee at the time appointment is scheduled, this fee will be deducted from the initial fee of $299 once the patient has been seen by the Doctor. If for some reason you will not be able to make your appointment we ask you call us to cancel at least 24hrs prior to your scheduled appointment. Clients that miss or cancel their appointments and do not reschedule within 30 days will be charged a $50 cancelation fee.