Appointments
-ACUPUNCTURE, GUA SHA, CUPPING THERAPY,NUTRITION AND HERBAL CONSULTATION
All Labs, herbs and supplements are an additional cost.
New patients, please fill out all of the new patient information below 24hours prior to first appointment.
Sliding scale options available for lower income patients.
Please email for information on cost of service, to set up an in-person or telemedicine appointment and for any other questions you may have: drgardner@pardonmyheartla.com
INSURANCE
I am out of network with all insurance companies. I am happy to verify your coverage to see if there’s a chance insurance might reimburse you.
Regardless of your coverage, I do require payment in full at the time of service. Following your appointment, we will submit an insurance claim for you.
If and when insurance pays, we will refund your credit or debit card—minus a 12% administration billing fee. We will reimburse you within 2 weeks of receiving funds.
COVID-19 INFORMED CONSENT TO TREAT FORM
I understand that the novel Coronavirus (COVID-19) has been declared a global pandemic by the World Health Organization (WHO). I further understand that COVID-19 is extremely contagious and may be contracted from various sources. I understand COVID-19 has a long incubation period during which carriers of the virus may not show symptoms and still be contagious.
I understand that I am the decision maker for my health care. Part of this office’s role is to provide me with information to assist me in making informed choices. This process is often referred to as “informed consent” and involves my understanding and agreement regarding recommended care, and the benefits and risks associated with the provision of health care during a pandemic. Given the current limitations of COVID-19 virus testing, I understand determining who is infected with COVID-19 is exceptionally difficult.
To proceed with receiving care, I confirm and understand the following (Initial in all seven places provided)