1. Registration Fee

Please bring a check to the office to cover the $50 registration fee plus the first two months of membership. The total check amount is typically $160 for an individual, $270 for a couple and $380 for a family. (Ex... $50 reg fee + $55 1st mo + $55 2nd mo = $160 for an individual membership plan)

2. Payment Authorization Form

The Payment Authorization Form allows you to choose the type of membership you will have with The Doc Shoppe. Please print the Payment Authorization form, then complete and sign it. Bring this form with you to the office.

 
 

3. Patient Agreement

Please print the Patient Agreement and Authorization to Receive PHI and to Accompany a Minor form, then complete it and sign where indicated. Bring Page 3 with you to the office.

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4. Call the office to schedule your first appointment.

We look forward to seeing you! Call (606) 620-9770.