Schedule Appointment with Dr. Kidgell - Body & Mind Healthcare

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First Name *

Last Name *

Phone *

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

Item	Quantity	Total
Chiro 5-1 Package		$300.00
Total: $300.00

CHIRO- I agree to the terms that if the patient/client "NO-SHOWS or NO-CALLS" for the scheduled Chiropractic appointment, it counts as one of the prepaid appts.

EMOTION CODE- I agree to the "No-Refund" policy that if there is a "No SHOW or a CANCELLATION" within 24 hrs of the appointment time. The missed appointment will count towards your package.