200 Corporate Plaza Islandia, NY 11749

Lose 4 to 20 Pounds in 1 Month
MY DIET MDS.COM
Tel 631-406-0026
My Diet MDs Financial Policy
Given below is our billing requirements and financial policy.
"My Diet MDs", is an affiliate of "Sky Fall Medical Services P.C." a New York State corporation.
"My Diet MDs" recognizes that certain financial situations can interfere with your willingness or ability to seek help.
"My Diet MDs" fees are based on a sliding fee schedule (A sliding fee schedule means that fees are determined based on your (or your family's) yearly income and number of dependents.
This sliding schedule ensures that you are not charged more than your financial situation permits and are scaled according to your family income and number of dependents.
Should extenuating circumstances arise, we are able to work around your needs; fees can be adjusted on a case-by-case basis.
Please be advised that " My Diet MDs" , its affiliate corporations and all physicians are "OUT OF NETWORK" providers. This means that we do not work directly with any insurance carriers, medicate, Medicare or any unions health plan.
"My Diet MDs" charges a fee of $50.00 per "ITEMIZED BILL " for each visit services.
"My Diet MDs" accept cash, Bank checks, postal money orders, credit or debit cards for its fee and other charges.
"My Diet MDs" holds a right to charge $100.00 if the appointments are not cancellation at least 30 hours in advance.
Patients are responsible for all collection charges including attorney fees in case the account is referred to an agency or an attorney for collections.
My fee for each visit is $_________ Plus the cost of (vitamins, supplements, foods and Tests etc)
Or
My fee for _____ weeks of program is $ _________ including the cost of certain vitamins, supplements payable As ________ initial deposit and balance in __________ equal installments.
I understand that if my weight management involves medications I will abide by the state and federal regulations and take medications exactly as prescribed.
I know that for effective weight management, I need to continue my treatment/counseling for the number of weeks first stated.
I also understand that my fee starts from today and is for continuous next number of weeks and I cannot pick and chose my days and weeks.
I further understand that my treatment is front loaded (lot is done in first two weeks) and will be responsible for entire fee even if I fail or elect not to receive any further services at any time.
Other special terms
I have read and understand all of the above and have agreed to these statements.
Patient’s Signature
Date
Patient Name:
- Home
- Patient Intake
- Special Prices (May Change)
- Natural Organic Detox $150
- Contact Us
- About Us
- B 12 Injections
- Phentermine Online
- Phendimetrazine 35 mg
- Adderall xr 30 mg
- Qsymia New Diet Pill
- HCG DIET
- Vitamin D Deficiency
- Low Testosterone symptoms
- Resveratrol 100 mg Benefits
- Rejuvenation
- Physicians
- Insulin resistance
- Buy Supplements
- 7 day Rapid Detox
- Beviq Diet pill
- 14-days Detox
- Kale Detoxification
- Detox Juice
- Guided Cleansing- Kunjan Kriya
- Groupon Detox Deal
- Healthy Eating Plan
- Saffaron
- Green Coffee Bean extract
- Raspberry Ketone
- White kidney bean
- Edamame
- Acai
- Hidden Reasons
- Adiponectin Burns Fat
- Apple Cider Vinegar
- Bile
- Biotin pills
- My Pyramid sample menu
- Zinc
- Chitosan weight loss
- Alpha Lipoic Acid (ALA)
- Colon
- CLA-Conjugated Linoleic Acid
- Organic total body detox
- L Caranitine 500 mg
- Potassium Magnesium Asparatate
- A Hidden Trigger of Obesity
- Raspberry Ketones
- ProbioticAcidophilus
- Metformin for weight loss
- Blood Tests
- How much Protein you need
- What is Your Tongue Telling
- Cyanocobalamine / Methylcobala
- Weight loss secrets
- 24 weight management tips
- HCS Garcinia Cambogia Extract
- Sex use it or lose it
- Juicing: How Healthy Is It ?
- Vitamins,A,B,C,D,E,K
- Vitamin B12 Boosts Energy
- weight loss and sex
- Weight Loss- Myths & Facts
- Healthy Ageing Sexual Vitality
- Anti-Ageing Diet
- Secrets for a Longer Life
- Low G. i. Foods
- Hypomagnesemia Low Magnesium
- Migranes and YOU
- Why we examine your Fingernail
- weight loss medical exam
- Lose weight eat more often
- Dispensing Phentermine by Drs
- Weight Loss Winner List
- Gut bacteria test
- Financial Policy
- Whole Eggs Vs Egg Whites
- Phentermine B12 inje, HCTZ
- You Should Not use Splenda
- Phentermine Plus B12 Injection
- Emotional Eating
- EZ Rapid weight loss
- 5Reasons You're gaining weight
- How much weight to lose
- 14 Tips to stick to Fitness
- PCOS and Weight Gain
- Hunger and Eating
- How to get rid of Belly Fat
- microwaved foods and you
- Eat Out Stil Lose weight
- Reduce Food and Sugar Cravings
- Gut Health
- Weight loss success test
- Fitness - Exercise Heart Rate
- E3 AFA Dietary Supplement
- The Anti-Allergy Diet
- 4 Great Smoothies
- 4 Hormones and weightloss
- Thinng hair and diseases
- Yoga Science Video
- weightgain is not your fault
- Normal Weight Fat Belly
- Yoga-Inspired Leg & Butt Exerc
- Yoga for weight loss and Life
- Yogasutra at mydietmds.com
- Yoga for weight loss
- Yoga 4 u at mydietmds.com
- Free Trial of Cialis
- Yoga Breathing Exercises
- Immunity Begins in the Belly
- Sun Salitation-Surya Namaskar
- Yoga Anulome Vilome Breathing
- Losing Weight Without Fad Diet
- The #1 Most TOXIC Food
- Coenzyme Q – 10
- Yoga VS Cardio VS Jogging
- Natural Detox Mung Soup
- 5 Minutes Desk Exercise
- 2000 Calorie diet plan
- Causes of Fatigue Sleepiness
- foods that HEAL your digestion
- Water and Weight Loss
- Week One of 28 days program
- Gyan Mudra
- Fasting Diets
- Is your DNA making you Obese ?
- My Diet Mds DASH Diet Plan
- 10 Health Benefits of Sex
- Low Testosterone & Your Health
- My Dietmds Natral Weightloss
- 15 Cancer Symptoms for men
- Complete Metabolic Panel
- Fat Cells
- Blog
- Victoza
- HYDRAFACIAL
- Micro-needling (PRP)&(Vampire Facial)
- Home
- Patient Intake
- Special Prices (May Change)
- Natural Organic Detox $150
- Contact Us
- About Us
- B 12 Injections
- Phentermine Online
- Phendimetrazine 35 mg
- Adderall xr 30 mg
- Qsymia New Diet Pill
- HCG DIET
- Vitamin D Deficiency
- Low Testosterone symptoms
- Resveratrol 100 mg Benefits
- Rejuvenation
- Physicians
- Insulin resistance
- Buy Supplements
- 7 day Rapid Detox
- Beviq Diet pill
- 14-days Detox
- Kale Detoxification
- Detox Juice
- Guided Cleansing- Kunjan Kriya
- Groupon Detox Deal
- Healthy Eating Plan
- Saffaron
- Green Coffee Bean extract
- Raspberry Ketone
- White kidney bean
- Edamame
- Acai
- Hidden Reasons
- Adiponectin Burns Fat
- Apple Cider Vinegar
- Bile
- Biotin pills
- My Pyramid sample menu
- Zinc
- Chitosan weight loss
- Alpha Lipoic Acid (ALA)
- Colon
- CLA-Conjugated Linoleic Acid
- Organic total body detox
- L Caranitine 500 mg
- Potassium Magnesium Asparatate
- A Hidden Trigger of Obesity
- Raspberry Ketones
- ProbioticAcidophilus
- Metformin for weight loss
- Blood Tests
- How much Protein you need
- What is Your Tongue Telling
- Cyanocobalamine / Methylcobala
- Weight loss secrets
- 24 weight management tips
- HCS Garcinia Cambogia Extract
- Sex use it or lose it
- Juicing: How Healthy Is It ?
- Vitamins,A,B,C,D,E,K
- Vitamin B12 Boosts Energy
- weight loss and sex
- Weight Loss- Myths & Facts
- Healthy Ageing Sexual Vitality
- Anti-Ageing Diet
- Secrets for a Longer Life
- Low G. i. Foods
- Hypomagnesemia Low Magnesium
- Migranes and YOU
- Why we examine your Fingernail
- weight loss medical exam
- Lose weight eat more often
- Dispensing Phentermine by Drs
- Weight Loss Winner List
- Gut bacteria test
- Financial Policy
- Whole Eggs Vs Egg Whites
- Phentermine B12 inje, HCTZ
- You Should Not use Splenda
- Phentermine Plus B12 Injection
- Emotional Eating
- EZ Rapid weight loss
- 5Reasons You're gaining weight
- How much weight to lose
- 14 Tips to stick to Fitness
- PCOS and Weight Gain
- Hunger and Eating
- How to get rid of Belly Fat
- microwaved foods and you
- Eat Out Stil Lose weight
- Reduce Food and Sugar Cravings
- Gut Health
- Weight loss success test
- Fitness - Exercise Heart Rate
- E3 AFA Dietary Supplement
- The Anti-Allergy Diet
- 4 Great Smoothies
- 4 Hormones and weightloss
- Thinng hair and diseases
- Yoga Science Video
- weightgain is not your fault
- Normal Weight Fat Belly
- Yoga-Inspired Leg & Butt Exerc
- Yoga for weight loss and Life
- Yogasutra at mydietmds.com
- Yoga for weight loss
- Yoga 4 u at mydietmds.com
- Free Trial of Cialis
- Yoga Breathing Exercises
- Immunity Begins in the Belly
- Sun Salitation-Surya Namaskar
- Yoga Anulome Vilome Breathing
- Losing Weight Without Fad Diet
- The #1 Most TOXIC Food
- Coenzyme Q – 10
- Yoga VS Cardio VS Jogging
- Natural Detox Mung Soup
- 5 Minutes Desk Exercise
- 2000 Calorie diet plan
- Causes of Fatigue Sleepiness
- foods that HEAL your digestion
- Water and Weight Loss
- Week One of 28 days program
- Gyan Mudra
- Fasting Diets
- Is your DNA making you Obese ?
- My Diet Mds DASH Diet Plan
- 10 Health Benefits of Sex
- Low Testosterone & Your Health
- My Dietmds Natral Weightloss
- 15 Cancer Symptoms for men
- Complete Metabolic Panel
- Fat Cells
- Blog
- Victoza
- HYDRAFACIAL
- Micro-needling (PRP)&(Vampire Facial)