Importance of compliance

Dear Patient:

At your initial evaluation, you will have the findings and treatment plan discussed with you. The recommendations will be documented and are shared as needed with your chosen insurance company and by law with your physician.
ANY alteration of the treatment plan effects the outcome.

We may, at the initial evaluation, determine that you would do better to return to your doctor so that your concerns about your treatment plan can be answered. The doctor may also be better able to explain to you the importance in following your treatment plan for the benefit of your general health. With your full understanding and anticipated compliance, we will be happy to get you scheduled as soon as possible.

Please sign signifying your understanding of this action.