Membership Plans

Membership Plan #1

  • 24/7 access after business hours
  • Extended Office Visits for Patient Evaluation
  • FAA Exams, All Classes
  • DOT & Admin. Exams
  • CLIA Waved Labs
  • Diagnostic Studies
  • Insurance is billed for the patient
  • Visits Covered by Annual Fee 15
Signup Here

Membership Plan #2

  • 24/7 access after business hours
  • Extended Office Visits for Patient Evaluation
  • FAA Exams, All Classes
  • DOT & Admin. Exams
  • CLIA Waved Labs
  • Diagnostic Studies
  • Insurance is billed for the visit
  • All visits included
Signup Here
Click Here For Full Comparison of the Tiers

Documents and Forms

Patient Forms

Release of Medical Records
Medicare Private Patient Contract
General Consent Form
Patient Registration Form

Member Contracts

Membership Tier 1 Contract
Membership Tier 2 Contract
Membership Tier 3 Contract

The forms provided here are primarily for reference use. During your initial appointment, we will have you fill out the forms, or you can request the most current version of the forms from us by using our contact form.