​NEED A MASSAGE/PHYSIO RX REQUEST

OR chiropodist, foot care, psychological services, orthotics, etc. ​

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Most insurance companies no longer require a physician prescription for the above services.

Please check with your insurance provider before

making a request here. 

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If you are requesting a prescription for insurance purposes there will be a fee. Please see list of fees. 

Please indicate what service you are requesting and for what condition. 

By sending a request here you are agreeing to pay the fee and an invoice will be emailed to you from Patient Serv. 

All fees are due upon receipt. Once payment is received you request will be submitted to you via email. 

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I agree to the above and would like to proceed with my insurance request  ​