Just click the PDF below, complete the form, then print. You may also fax it to us at (512) 394-6572.
Our office is a contracted provider for virtually every health insurance plan. If you don’t know your benefits, don’t worry — we’ll check them for you. Call us at (512) 386-1876. We’ll take care of everything, and then call you back with the information.
We offer a substantial time-of-service discount to our patients who pay out of their own pockets. Call us at (512) 386-1876 and ask for the details!
As an additional convenience, we also accept Bitcoin and Ethereum as payment for your treatments.