Please note thatif your claim has not been approved you will need to pay for your consult onthe day and seek reimbursement.
There may be an“out of pocket expense”. please turn over …..
PAYMENT ISREQUESTED AT TIME OF SERVICE. WE ACCEPT CASH, CREDIT
CARDS AND EFTPOS!
A 24 HOURCANCELLATION NOTICE IS REQUIRED IF YOU’RE NOT ABLE TO
ATTEND THESESSION TIME OTHERWISE A PAYMENT IS REQUIRED FOR
THE SESSION NOTATTENDED. THIS WILL ENABLE OTHER CLIENTS TO USE
THE ALLOTTEDTIME. IF RUNNING LATE FOR YOUR APPOINTMENT, THE
SESSION WILL BESHORTENED SO THAT THE NEXT CLIENT IS NOT
INCONVENIENCED.
PLEASE CHECK THEBOX TO ACKNOWLEDGE AND ACCEPT
RESPONSIBILITYFOR PAYMENT OF ALL SESSIONS.
I consent toSmart Health Training & Services obtaining and giving
information, bothverbally and in writing, to/from other Health Professionals
pertaining to themedical conditions, where relevant, to the treatment being
received at SmartHealth Training & Services. These professionals may
include your GP,Case Manager, Radiologist. Etc
InformationConsent *select one