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[email protected] 650.494.3199 Bay Area Homeopathy Lisette Narragon 160 Main Street, Suite A Los Altos CA 94022 Financial Policy Insurance Thank you for choosing homeopathy as part of your health care. Please be aware that homeopathy is not covered by any insurance company in California. However I can provide a receipt for reimbursement through a Flexible Spending Account or Health Spending Account. Fee Schedule Initial Consultation $320 Follow-up, in person or on phone (app. 1 hour) $130 Acute illnesses/Short phone calls/ Reworking of case $45-90 These visits include free 5 minute update calls during my call in hours which are posted on my website. If more time is needed, a 15 minute call can usually be scheduled later that same day, charged at the hourly rate. Weekend calls, texts, and emails If I need to respond on the weekend there is a charge of $25 Treatment Package $200 per month for 4 months Includes initial consultation, follow up visits, and one phone call per week. I agree to make four payments of $200 each by this date _______________________ Cancellations Unless you have a medical emergency, there will be a charge for appointments cancelled or missed with less than 24 hours notice. Office Visits My policy is to book your next appointment at the end of each office visit. Payment may be made in cash, check or credit card. I agree to all the financial policies of Lisette Narragon. _________________________________ ___________________ Patient Signature Date

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[email protected] 650.494.3199

Bay Area Homeopathy Lisette Narragon 160 Main Street, Suite A Los Altos CA 94022

 

Financial Policy Insurance Thank you for choosing homeopathy as part of your health care. Please be aware that homeopathy is not covered by any insurance company in California. However I can provide a receipt for reimbursement through a Flexible Spending Account or Health Spending Account. Fee Schedule Initial Consultation $320 Follow-up, in person or on phone (app. 1 hour) $130 Acute illnesses/Short phone calls/ Reworking of case $45-90 These visits include free 5 minute update calls during my call in hours which are posted on my website. If more time is needed, a 15 minute call can usually be scheduled later that same day, charged at the hourly rate. Weekend calls, texts, and emails If I need to respond on the weekend there is a charge of $25 Treatment Package $200 per month for 4 months Includes initial consultation, follow up visits, and one phone call per week. I agree to make four payments of $200 each by this date _______________________ Cancellations Unless you have a medical emergency, there will be a charge for appointments cancelled or missed with less than 24 hours notice. Office Visits My policy is to book your next appointment at the end of each office visit. Payment may be made in cash, check or credit card. I agree to all the financial policies of Lisette Narragon. _________________________________ ___________________ Patient Signature Date