Secure Online Payments

In order to confirm your New Patient appointment and reserve the doctor's time, please purchase your $47 New Patient Special. Your appointment will not be confirmed unless we receive payment. Please call 802-985-9850 if you have any questions.

Order Details

Online Special New Patient Consultation and Exam with follow up visit to review Findings and Recommendations included

Total:

Contact / Shipping

Billing Address

Billing

what's this?

I authorize Wellspring Chiropractic Lifestyle Center to debit the account listed hereon $47.00, & agree to perform the issuer obligations. I affirm that the information entered on this form is true and correct and further declare that I have read, understand and accept Wellspring Chiropractic Lifestyle Center Terms as referenced in the [Terms of Use] link below.

| |

Wellspring Chiropractic Lifestyle Center
4076 Shelburne Rd Shelburne, VT 05482
(802) 985-9850

To protect your client's privacy, our secure server uses secure socket layer (SSL). This ensures that the billing information is encrypted and cannot be read as this information is transferred over the internet.