Refund Policy

If you would like to request a refund for a credit balance on your account, please complete the following process to ensure proper handling and timely refund processing:

Complete the Refund Request form with all required information or call our Billing Department, Tuesday – Friday, 9:00 a.m. – 5:00 p.m., at (561) 549-9090.
Our Billing Department will review your account, including any outstanding balances and pending insurance claims.
If approved, your refund will be processed according to our billing procedures.
Please allow up to 30 business days for your financial institution to process and issue your refund.
If additional balances remain on your account, they may be deducted from the refund amount.

Please note:

Refund requests are reviewed individually before approval.
All insurance claims must be processed before a refund can be issued.

Please complete the Refund Request form below. By submitting the form, you acknowledge that refunds may take up to 30 business days to process and that your account will be reviewed before a refund is approved.

Refund Request Form

Date of Request

Patient Name

First Name

Last Name

Date of Birth

Phone Number

Email Address

Please check each line below to acknowledge receipt of Refund Policy.*

Patient acknowledges that refunds may take up to 30 business days, once your account has a zero balance or reflects a credited balance.

Patient acknowledges that account will be reviewed for prior unpaid balances before approval can be determined.

Patient acknowledges that all insurance claims must be processed before a reimbursement can be issued.

I would like to pick up my refund check at:

I would like my refund check mailed to:

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Please note when selecting the option to have a check mailed: the fee to have the refund check mailed will be $10. This includes certified mail and return receipt, which will be deducted from the refunded amount. If the check is lost in transit to the address provided, a stop check fee of $50 and a reprocessing fee of $25 will be deducted from the original refund amount.

Acknowledgment

By checking this box, I acknowledge that I read and understood the Refund Policy.

Refund Policy

Please note:

Refund Request Form

Patient Name

Please check each line below to acknowledge receipt of Refund Policy.*

Acknowledgment

Additional Resources

International Patients

Medical Records

Prescription Renewals

Refund Policy

Insurance