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IV Expenses

__X__  History and Physical with Dr. Arthur for Prescriptions of I.V. TGGRS Therapy
      or physicals for Naltrexone or Antabuse only.

__X__  Acupuncture/Massage/Sauna /Footbath (1/2 hr or 1 hr sessions) per day.
      You can expect approximately _30 _(1/2 hr units of any of the above modalities daily)

__X__  I.V. Amino Acid Therapy ( $880.00 each per double dosage )
      You can expect approximately _ 10__ Treatments at $_880.00__per treatment.
      (Including 6 boosters I.V’s over a 6 month period or 16 treatments total)

__X__  I.V. Maintenance Oral Formula ($85.00 per bottle or Box)__6__Bottles/Boxes purchased
      (One bottle or weekly box per week for 6 weeks)

__X__  Neurotransmitter testing (dopamine/ gaba/ endorphines/ encephalines / serotonin/ cortisol)
      before and after testing treatment.

__X__  1:1 Counseling/Case Management
      Number of sessions is ____20 individuals_____

__X__  Relapse Prevention Group.
      Friday and Wednesday nights 6:00 pm
      Number of sessions are____10 group sessions________
      (For every 10 R.P groups paid and attended after initial ten received, an additional I.V
      will be administered at no cost to the patient for purposes of continued care.)

__X__  Any additional I.V. infusions: ADDITIONAL COSTS
      $ 440.00 per two hr. TGGR I.V
      $ 3400.00 per ½ order TGGRS treatment which is 13 (two hr.) infusions.
      $ 125.00 per 1 hr. Glutathione treatment.
      $ 125.00 per 1 hr. IV. Vita. C treatment.

Discount for purchase in bulk orders of 10 Infusions

Cost of the Treatment Program ----------- $ ___13,800.00_____

Reduced fees are not available at this program. I understand that the above is only an estimation of my treatment cost and the actual cost may be higher or lower depending on my treatment needs as determined by my counselor, probation officer/evaluator, and/or the requirements of the court/treatment program. No refunds of monies paid will be returned for any reason. I agree to pay the treatment fees that apply to me. I understand that in order to receive reimbursement form my insurance company it is my responsibility to submit the required paperwork. Treatments start on a Monday and are arranged for 10 days in a row minus Saturday and Sunday. Please contact our front desk for an appointment at 303-782-0599