By my signature below, I understand, acknowledge, and agree that I am fully responsible for payment of services provided to me by Virginia Infusion Therapies and that payment must be made in full by cash, or credit card at or before the time of service.
I understand that treatment and services provided by virginia Infusion Therapies may not be covered by my insurance. Virginia Infusion Therapies does not contract with any insurance plan. Virginia Infusion Therapies will provide information to me to assist me in my claim for reimbursement to my insurance carrier, but will not submit claims to insurers on my behalf. I further acknowledge and agree that if I choose to submit any bill or itemized receipt to an insurance carrier for reimbursement for these services, that Virginia Infusion Therapies is exempt from any dispute regarding reimbursement.
To fairly and effectively serve patients who wish to receive treatment, the following cancellation policy has been implemented. By your signature below you acknowledge and agree to the following cancellation policy:
Short (Approx. 40 min) infusions must be cancelled at least 72 hours in advance. Short (Approx. 40 min) infusions cancelled at least 72 hours in advance will receive a full refund. Short (Approx. 40 min) infusions cancelled less than 72 hours in advance will incur a $325 charge, payable by funds pre-paid to your account or charged to your credit card on file.
Long (Approx. 4 hr) infusions must be cancelled at least 1 week in advance. Long (Approx. 4 hr) infusions cancelled at least 1 week in advance will receive a full refund. Long (Approx. 4 hr) infusions cancelled less than 1 week in advance will incur a $500 charge, payable by funds pre-paid to your account or charged to your credit card on file.
Virginia Infusion Therapies
The First Ketamine Clinic in Northern Virginia
Virginia Infusion Therapies is one of the the first Ketamine Clinics in Northern Virginia, and the first clinic in Loudoun County to provide Ketamine infusion therapy for the treatment of Major Depression and Pain Conditions. The clinic was established by four physicians in Loudoun who, through their professional experiences in medicine and their personal family experiences with depression, recognized that there are major problems in the recognition and treatment of depression. They recognized that Major Depression, Post-Traumatic Stress Syndrome, and some pain conditions are often medical emergencies that requires treatments that are more effective… and more effective IMMEDIATELY.
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Request your free 15 minute phone consultation and speak with a clinician about ketamine infusions and how we can help you live your happiest, healthiest life.