Please Print the following documents and bring them filled out to your appointment.
*There is a deposit for new patients, which will be refunded only if the appointment is cancelled with more than 2 business days notice. See Cancellation Policy below.*
Cancellation Policy: When you call and schedule an appointment, time is reserved especially for you. There is a deposit for new patients, which will be refunded only if the appointment is cancelled with more than 2 business days notice. For existing patients please allow a 48 Hour advance notice if you can not make your set appointment or a cancellation fee of $50.00 will be charged to your account.
For Dr. Jeremy Schiermeyer & Dr. Candice Mathis: The patient is responsible for paying for the visit at the time of your appointment. Upon checkout, you will receive a “Super Bill” receipt. This “Super Bill” will have all necessary service, diagnostic, and doctor codes your insurance company will need. Please contact your insurance on where to send your “Super Bill”, your insurance can then process and reimburse YOU (the patient) for the percentage that it covers for Chiropractic Care.
Medicare All Doctors: You are responsible for paying for your visit at the time of your appointment. Our office will submit claims to Medicare, and Medicare will reimburse YOU (the patient) for the percentage that Medicare covers for Chiropractic Care.
"I started the Sunshine Protocol with Dr. Jeremy. Ever since we started this protocol my mental clarity has improved by leaps and bounds. I used to feel in a "fog" or mentally "hung over" even though I don't drink at all. The fog has been lifted and i…
"Dr. Jeremy is an absolute genius at what he does. He has completely resolved stubborn health issues for me for which other doctors could not provide any relief. He's very professional, personable, and easy to be around. The office staff here is also super easy to work with…
"I was referred by a friend and very happy so far. Dr. Candice was excellent and was very genuine towards seeing that I get healthy again. I appreciate the honest approach to treatment. Thank you."