Marguerite Dinkins, L.Ac.   6363 7th Ave S Seattle, WA 98108. www.mdinkins.com

Clinic Financial Policy

Time-of-Service Discount Fees:
First Office Call		(in person)			$120.

Return Office Call 	(in person)			$120.

ONLINE Virtual Consultation/ Herbal Consult		$95.* 	(*NO acupuncture included)
 			(Online via Zoom)

Billed payments:
Personal Injury Protection (PIP)	treatment visits may be billed to your auto insurance company when appropriate.

*Chinese herbal medicine varies in price and is not included in the above fees for Virtual Consultation/ Herbal Consult. Payment for Chinese herbal medicine is paid directly to the pharmacy where it is filled.

Our clinic is not set up to file insurance claims, or to accept delayed payments. Payment in full is due at the time of service. Payments are by cash or check; credit / debit cards / online apps are not accepted. I can provide you with a receipt / superbill that includes the appropriate codes, for your records or to send to your insurance company. 

Occasionally other arrangements for payment can be made. Please notify me if you would like to discuss other options.

A broken appointment is a loss to everyone. Clinic hours are limited and there is a waiting list. Please inform me one day/ 24hrs  in advance if you are unable to keep your appointment so that another patient may take your place. Appointments cancelled with less than 24 hours notice and appointments missed with no notification will be charged in full for that appointment. Please pay for the missed visit at or before the next appointment. Please show respect and plan ahead if you must cancel or change your appointment.

By signing this form, I am indicating that I understand and accept this policy.

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Financial Consent revised 2023–11-10