New Patient Information Policy Form

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Dr. Sharif’s Natural Dermatology Office Cash Or Direct Pay Practice Policy

Please note:

We offer either cash visits OR direct pay visits to our patients at our natural dermatology clinic. We do NOT bill insurance companies at this office. Our services are pay-at-time of service. We will supply you with a Superbill with the necessary codes to self-submit to your insurance carrier. We realize you have choices for your health care providers, and we wholeheartedly appreciate you choosing Dr. Sharif's dermatology practice for your dermatological care!

Our Office Fees for CASH Visits:
Initial Office Visit (1.5 hours): $375
Subsequent Office Visit (45 minutes): $185.00

Our Office Fees for Our DIRECT PAY Visits:
The Direct Pay option involves a monthly, quarterly, or annual membership fee paid directly by the patient to the healthcare provider. This fee can be paid ahead of time, on a monthly or quarterly or annual basis. We have three different options for Direct Pay:
Basic Direct Pay: $175/month (2 visits/month)
Premium Direct Pay: $275/month (3 visits/month)
Deluxe Direct Pay: $350/month (unlimited visits/month)

All Direct Pay plans are subject to a one-time joining fee of $350 3-month minimum commitment required, paid during the first visit.

CANCELLATION / NO SHOW Policy:
Due to the nature of our naturopathic/homeopathic visits (which differ from the rather short visits with conventional medical practitioners), we dedicate 45-90 minutes per visit specifically for you.
If you do not show up for your appointment or neglect to give us an advanced notice of at least 24 hours, you will be charged a fee of $100.

NOTE: Payment is due at the time of service. We accept cash, check or credit cards.

Note: Often Dr. Sharif offers a homeopathic remedy to his patients during the visit. The charge for this remedy is $15 which is not reimbursable by insurance companies.

FMLA (Paid Family and Medical Leave): We do NOT fill out FMLA forms for patients. If you need these forms filled out, please seek help from other medical clinics.

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