PAYMENT POLICY FOR YOUR NEW PATIENT
FIRST VISIT & DOWNPAYMENT & 2ND VISIT (FOLLOW UP) APPOINTMENTS

New Patient Visit Downpayment

Thank you for scheduling an appointment with Dr. Michael Wald of Integrated Nutrition of Mount Kisco, PLCC. We are happy to schedule your New Patient Appointment and kindly require a deposit of $175.00.  This downpayment is fully credited towards your new patient visit and is non-refundable. Your downpayment is applied in full towards your new patient visit fee of $430.00 unless you fail to schedule and/or complete your New Patient Visit with 60 days. After 60 days your deposit will be entirely forfeit.  Dr. Michael Wald is a sought after health professional with limited time to see new patients. If you should cancel your appointment your down payment will be applied in full towards a rescheduled new patient appointment visit, on a one-time basis only. You will have one additional opportunity within the 60 day period to reschedule your New Patient Visit if you cancel your first scheduled New Patient appointment.  If you fail to satisfy our cancellation policy as stated herein, and still wish to see Dr. Wald as a New Patient, you will have to pay another downpayment fee of $175.00 and the same stipulations as described above will apply to this second downpayment. Our office reserves the right not to reschedule a New Patient Appointment after your first cancellation. If we agree to re-schedule a New Patient Appointment for you after 60 days, or at anytime, you will be required to pay another new patient appointment down payment in the amount of $175.00 and the stipulations above will apply to this payment. Thank you for your understanding.  

New Patient Visit

All payments for visits and services paid during your New Patient Appointment are non-refundable for any reason. Your payment is an acknowledgement of your complete satisfaction and agreement of our non-refund policy for all services that you have recommended and paid for.  Currently, the full New Patient Visit fee is $430.00, but is subject to change without prior notice. Dr. Wald is not a licensed medical doctor, but earned his MD degree for educational purposes only. He is a licensed doctor of chiropractic and a Certified Dietitian-Nutritionist and Certified Nutritional Specialist (CNS) and is double board certified in nutrition. For a further descriptions of Dr. Wald's credentials please consult your New Patient Paperwork and the About Us section of this website. Thank you very much.

Custom Supplement Patient (if you should agree to purchase a custom made product)

CUSTOM PRODUCT NO REFUND POLICY. This product is being produced for you and only you. You will be purchasing several months of product in advance. No portion of your custom product will be refunded for any reason. Paying for your custom product below is an acknowledgement by you of our no-refund policy and your complete satisfaction. Your order below, and/or your use, acknowledgement and/or permission to purchase this product, further acknowledges the following: 

 

Custom Supplement Acknowledgment and Agreement/Permission

Thank you for making the decision to purchase a custom nutritional supplement. You are acknowledging and agreeing to the followingYour custom product is meant to enhance your overall nutritional efforts. You have chosen either a custom powdered product or capsules for one full year or thereabouts; due to manufacturing techniques your custom product may contain 2-3 weeks less or more product than the full year’s supply that you ordered. Your custom product contains a variety of nutritional compounds chosen by Dr. Michael Wald based upon his training and experience in the field of nutrition. The dosages/levels/amounts of nutritional supplements in terms of units (for example - milligrams(mg), grams (g), IU (international Units), but not limited to these units, may be higher or lower than those of the Recommended Daily Allowances (RDA), Recommended Daily Intakes (RDI), Recommended Daily Values (RDV) and/or other dosages/levels/amounts or other units that may be considered as guides and/or recommendations or otherwise suggest guidelines for individuals.  Your compounded supplement is not a substitute for a balanced diet.  Your compounded supplement is not a substitute for sound medical or health advice. You are free to discuss Dr. Wald’s recommendation for a custom product with your medical doctor or legal council before signing this agreement. No claims whatsoever are implied or promised regarding your health condition(s) and use of your custom product. Your custom product is not a treatment for any medical or health condition. Your compounded product is non-refundable, in part or full, for any reason whatsoever including, but not limited to, adverse reaction and intolerance. Once you or Dr. Wald has placed your custom product order, either in the form of cash, credit card, money order, online or any other form of payment, you are agreeing and acknowledging this no refund policy for any reason whatsoever.  If any portion of this agreement is deemed unenforceable the remainder of this agreement shall remain intact. There are no exceptions to this no-refund policy.  Your compounded supplement is considered experimental and/or Investigational (description below):

 Investigational" or "Experimental Nature of Custom Product or other services provided by Dr. Michael Wald during the course of your health work with him (see below)

Some of the products and/or services, but not limited to them, may be deemed Investigational and/or experimental as defined here. By Purchasing and/or receiving such services you are acknowledging the following: "Investigational" or "experimental" refers to the use of a service, procedure or supply that is not recognized by your insurance company and/or the FDA (Food and Drug Administration) and/or the AMA (American Medical Association) or other boards and/or governing bodies or organizations, as standard medical care for any condition, disease, illness or injury . A service, procedure or supply includes, but is not limited to the diagnostic service, treatment, facility, equipment, drug or device. A service is considered investigational (experimental) if any of the following criteria are met:  The services, procedures or supplies requiring Federal or other Governmental body approval, such as drugs and devices, do not have unrestricted market approval from the Food and Drug Administration (FDA) or final approval from any other governmental regulatory body for use in treatment of a specified condition. Any approval that is granted as an interim step in the regulatory process is not a substitute for final or unrestricted market approval. There is insufficient or inconclusive medical and scientific evidence to permit the Plan to evaluate the therapeutic value of the service, procedure or supply. (Adequate evidence is defined as at least two documents of medical and scientific evidence that indicate that the proposed treatment is likely to be beneficial to the member.) There is inconclusive medical and scientific evidence in peer-reviewed medical literature that the service, procedure or supply has a beneficial effect on health outcomes.  The service, procedure or supply under consideration is not as beneficial as any established alternatives. There is insufficient information or inconclusive scientific evidence that, when used in a non-investigational setting, the service, procedure or supply has a beneficial effect on health outcomes or is as beneficial as any established alternatives. If any portion of this notice is deemed unenforceable the remainder will remain potentially enforceable and in effect. Reversal of the payment/charge for your custom product will be met with legal and/or other remedies and the purchaser will be held fully liable for all fees, including, but not limited to, penalties and monies incurred during the course of obtaining payment in full.  Non-payment will result in potential damage to your credit report.

 

 

 

*Your deposit fee and your entire new patient visit fee including all fees paid towards all services performed during any of your visits, are non-refundable for any reason including sickness, death and for unforeseen circumstances not listed here.. The reason for this strict policy involves our limited schedule to see people in need and loss of revenue that we would experience with empty spots in our schedule.  The above policy may change at any time without prior notice. Dr. Michael Wald and Integrated Nutrition of Mount Kisco, PLCC/Blood Logic, Inc. reserves the right not to schedule any person again after a single cancellation without cause or reason and the above financial policies remain in force.