Name: Email: Existing patient: Yes | No If you’ve seen us before, then you’re an existing patient. Phone: Dues:Monthly | Annually Save 10% off the monthly amount when you take care of dues annually. Type:Individual | Family Wellness for you, savings for the whole family. Family*:Yourself + 1 | Yourself + 2 Or More Member(s) to be included: *Family is defined as anyone living at the same address and is partnered with or is a dependent of one of the members and on the same tax return.
