Schedule Appointment with Rivercreek Wellness

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First Name *

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Notes to Business (your address or any special notes about your order)

Item	Quantity	Total
4 Follow Up Visits		$880.00
Total: $880.00	Coupon:

I agree to pay the full amount of the package price. If I am on a monthly payment plan, I agree to pay the full amount. If I do not pay the full amount, Rivercreek Wellness will work with a collection agency to collect outstanding debts.

Packages are nonrefundable after 24 hours of sale date and time. Packages are nontransferable.