Call Denver location: 704-483-2200

Call Lincolnton location: 704-735-3116

Forms and Insurance

Fees & Insurance

As a courtesy to our patients, our office will file insurance claims for you. We are contracted with most of the major insurance companies. Please bring your insurance card with you at the time of your scheduled appointments.

It is the patient’s responsibility to know their insurance policy and what their insurance will and will not cover. We do verify your insurance but with so many different policies our office cannot guarantee that your insurance will cover what testing may be required.

Patients are financially responsible for all charges, including any deductible and/or copayments. If you have no insurance coverage, payment is due in full at the time of service unless prior arrangements have been made. For your convenience, we accept cash, personal checks, MasterCard, Visa, and Discover.

Our office does require payment on accounts with balances that are over 60 days old. If monthly payments are not made on accounts patients can be dismissed from practice and turned over to a collection agency.


Patient Registration Information
New Patient Form – Adult Male
New Patient Form – Adult Female
New Patient Form – Pediatric Male
New Patient Form – Pediatric Female

Quick references with though you might find helpful: (botox and juvederm) (Xymogen) (Ortho Molecular) (American Academy of Family Practice) (American Academy of Anti-Aging) (Diagnos Techs) (Spectracell Labs) (Genova Diagnostics)