ENROLLMENT FORM

Individuals & Families

Please complete a profile for EACH INDIVIDUAL (adult or child) to be included on your account. If this person(s) is being added to an existing family account, we can do that manually after submission. 

We require payment of an $80 enrollment fee (per household) and the initial month's membership fee(s) (pro-rated based on start date) before first visit or service begins. Credit card entered here not charged until membership finalized. 

Auto-payment with credit/debit card on preferred day of month is required for payment of future fees. Full payment policies here